Incidence and clinical relevance of cage subsidence in anterior cervical discectomy and fusion: a systematic review

Acta neurochirurgica
Iris NoordhoekCarmen L A Vleggeert-Lankamp

Abstract

The placement of intervertebral cages in anterior cervical discectomy (ACDF) supposedly maintains foraminal height. The most commonly reported cage-related complication is subsidence, although it is unknown whether a correlation between subsidence and clinical outcome exists. To assess the incidence and relevance of subsidence. Literature searches were performed in PubMed, MEDLINE, Embase, Web of Science, COCHRANE, and CENTRAL. The inclusion criteria were as follows: ≥ 20 patients, ADCF with cage, subsidence assessed, and primary data. Risk of bias was assessed using adjusted Cochrane checklists. Seventy-one studies, comprising 4784 patients, were included. Subsidence was generally defined as ≥ 3-mm loss of height comparing postoperative intervertebral heights with heights at last follow-up. Mean incidence of subsidence was 21% (range 0-83%). Of all patients, 46% of patients received polyether-ether-ketone (PEEK) cages, 31% received titanium cages, 18% received cage-screw-combinations, and 5% received polymethyl-methacrylate (PMMA) cages. Patients treated with cage-screw-combinations had significantly less subsidence than patients treated with PEEK, titanium, or PMMA cages (15.1% vs. 23.5% vs. 24.9% vs. 30.2%; p < 0.001). Thirt...Continue Reading

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May 18, 2020·Journal of Biomedical Materials Research. Part a·Bijan AbarJennifer L West
Jun 12, 2020·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Ravi VermaSheeraz Qureshi
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Dec 9, 2020·Journal of Biomaterials Applications·Xiao HanPing Yang
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Jun 3, 2021·Journal of Clinical Medicine·Kathryn-Anne JimenezByung-Ho Lee
Nov 5, 2020·Current Problems in Diagnostic Radiology·Licia P LunaMelike Guryildirim

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Statistical Package for the Social Sciences ( SPSS )

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