Stand-alone Anchored Spacer Versus Anterior Plate for Multilevel Anterior Cervical Diskectomy and Fusion

The purpose of this study was to compare the clinical outcomes and radiological changes of 3- and 4-level anterior cervical diskectomy and fusion with stand-alone anchored spacers and with traditional anterior plates. A total of 51 consecutive patients with cervical spondylotic myelopathy who underwent 3- or 4-level anterior cervical diskectomy and fusion were divided into 2 groups: group A (n=23) received anchored spacers and group B (n=28) received an anterior plate. Mean follow-up was 14.6 months. Solid fusion was achieved in all patients at final follow-up. No significant difference existed between multilevel anterior cervical diskectomy and fusion with stand-alone anchored implants and with an anterior cervical plate in achieving clinical symptomatic improvement, fusion rate, and lordotic curvature improvement. The dysphagia rate of group A at 2-month follow-up was significantly lower than that of group B. No statistically significant difference existed between the 2 groups at the other time points. Swallowing Quality of Life of group A at 48 hours and 2 months postoperatively were significantly higher than those of group B. The thickness of the prevetebral soft tissue at 48 hours and 2 months postoperatively were significantly lower in group A than in group B. Compared with using an anterior plate, anterior cervical diskectomy and fusion with a stand-alone anchored spacer achieved a similar clinical outcome with less irritation to the prevertebral soft tissue and a lower dysphagia rate in the first 2 months.