Improved Dysphagia Outcomes in Anchored Spacers Versus Plate-Screw Systems in Anterior Cervical Discectomy and Fusion: A Systematic Review.

Journal Article (Journal Article)

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To perform a systematic review of clinical outcomes between stand-alone anchored spacers and traditional cages with plate fixation for dysphagia and pseudoarthrosis using data from clinical trials. METHODS: Our search protocol was added to PROSPERO register and systematic review using PRISMA method was performed. Then, we systematically searched for studies addressing stand-alone anchored spacers in patients who underwent ACDF. Mean Neck Disability Index (NDI), dysphagia incidence % (Dinc%), and Swallowing-Quality of Life (SQOL) scores during preoperative, immediate postoperative and last follow-up visits were extracted. Chi-square and analysis of variance (ANOVA) tests were used for statistical comparisons (P ≤ .05). RESULTS: The initial search generated 506 articles in CENTRAL and 40 articles in MEDLINE. Finally, 14 articles were included. Total number of patients was 1173 (583 anchored stand-alone and 590 plate). Dinc% scores were statistically significantly lower in the stand-alone anchored spacer compared to the plate-screw construct (P ≤ .05). ANOVA showed no statistically significant difference in the comparisons of SQOL. On the other hand, NDI scores were statistically significantly lower in baseline of stand-alone anchored spacer and the plate-screw construct compared with both immediate postoperative and last follow-up visits (P ≤ .05). CONCLUSIONS: Our study results revealed that the stand-alone anchored spacers were associated with less dysphagia in the immediate and last follow-up.

Full Text

Duke Authors

Cited Authors

  • Gabr, MA; Touko, E; Yadav, AP; Karikari, I; Goodwin, CR; Groff, MW; Ramirez, L; Abd-El-Barr, MM

Published Date

  • December 2020

Published In

Volume / Issue

  • 10 / 8

Start / End Page

  • 1057 - 1065

PubMed ID

  • 32875838

Pubmed Central ID

  • PMC7645096

International Standard Serial Number (ISSN)

  • 2192-5682

Digital Object Identifier (DOI)

  • 10.1177/2192568219895266


  • eng

Conference Location

  • England