Comparison between plate cage system and stand-alone cage in the treatment of cervical spondylotic myelopathy patients with cervical kyphosis: clinical and radiographic outcomes
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background To compare mid-term outcomes of plate cage systems (PC) vs. stand-alone cages (SA) in two-level ACDF for cervical spondylotic myelopathy (CSM) with cervical kyphosis, and to assess the influence of preoperative segmental kyphosis reducibility on sagittal alignment maintenance. Methods This retrospective cohort analyzed 130 patients (SA = 64, PC = 66) with ≥24-month follow-up. Radiographic parameters (cervical lordosis [CL], fusion segmental lordosis [FSL], disc wedge, C2 SVA) and clinical outcomes (NDI, VAS, JOA, EQ-5D, dysphagia) were assessed preoperatively, postoperatively, and at final follow-up. Patients were stratified based on preoperative reducibility of segmental kyphosis. Results Both groups showed comparable clinical improvement ( p < 0.05) and fusion rates (93.8% SA vs. 95.4% PC, p = 0.667). SA had shorter operation time (78.0 ± 11.5 vs. 86.6 ± 12.5 min, p < 0.001), less blood loss (193.0 ± 85.6 vs. 256.7 ± 110.3 mL, p < 0.001), and lower dysphagia incidence (12.5% vs. 20.3%, p = 0.014). However, the PC group demonstrated superior maintenance of cervical sagittal alignment in CL (13.6° ± 0.9° vs. 12.3° ± 2.4°, p < 0.001), FSL (13.2° ± 1.2° vs. 11.9° ± 2.9°, p = 0.001), and disc wedge (10.2° ± 1.3° vs. 8.9° ± 2.6°, p < 0.001) at follow-up, particularly in patients with non-reducible kyphosis ( p < 0.05). Conclusion SA offers operative efficiency advantages, while PC is more effective in maintaining sagittal alignment, especially in rigid kyphosis. PC is recommended for patients with non-reducible cervical kyphosis.
Source: Frontiers in Surgery
Authors: Chao Wang, Shu Liu, Jiabin Yuan, Zhicai Shi
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7130480864