Standalone anchored cages produced two-year outcomes comparable to traditional plate-cage constructs in three-level anterior cervical discectomy and fusion while shortening surgery and reducing blood loss, according to a study published Nov. 5 in the International Journal of Spine Surgery.
The study, led by researchers from Singapore, retrospectively compared 50 patients in the country who underwent three-level contiguous ACDF for degenerative cervical disease at two tertiary centers. Twenty-five patients received the Coalition standalone anchored cage from Globus Medical. The other 25 received an anterior plate paired with an interbody cage.
The standalone group was older, averaging 68 years versus 55.8 years. It also had much higher rates of ischemic heart disease, 52% versus 8%. Even so, standalone cases averaged 283.6 minutes of operative time versus 310 minutes. Estimated blood loss was 106.2 milliliters versus 167.2 milliliters.
At two years, both groups showed similar improvements in pain, disability and neurological function. Per-level fusion reached 98.7% with standalone cages and 96% with plate-cage constructs, a difference that was not statistically significant. Dysphagia occurred in 8% of patients in each group. Three standalone patients had cage subsidence, compared with five plate-cage patients.
The authors called for prospective, multicenter randomized trials to confirm the findings.
Earlier research has supported standalone cages in one- and two-level ACDF. This study is one of the few to test them in three-level disease, where plates have traditionally been the default.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
