SynthesisActa neurochirurgica2018
Incidence and clinical relevance of cage subsidence in anterior cervical discectomy and fusion: a systematic review.
Synthesis in Acta neurochirurgica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
82 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Long-term effectiveness of stand-alone anchored spacer in multilevel anterior cervical discectomy and fusion compared with cage-plate system: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Factors influencing cage subsidence in anterior cervical corpectomy and discectomy: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Pooled it
- Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis.Journal of orthopaedic surgery and research · 2020Pooled it
- Comparison between Three-Dimensional Printed Titanium and PEEK Cages for Cervical and Lumbar Interbody Fusion: A Prospective Controlled Trial.Orthopaedic surgery · 2023Trial
- Systematic Review of Bioactive Glass Cages in Anterior Cervical Discectomy and Fusion.International journal of spine surgery · 2026Article
- Is preoperative cervical range of motion associated with cage subsidence after anterior cervical discectomy and fusion?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Single-level anterior cervical discectomy and fusion for degenerative disc disease: a retrospective, two-center comparative analysis of stand-alone cage versus cage-plate constructs.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Risk of subsidence following ACDF with the coalition™ (Globus Medical) cage: a multivariable analysis identifying preoperative radiculopathy as the primary risk factor.Acta neurochirurgica · 2026Article
- C- VBQ versus CT Hounsfield units in predicting cage subsidence following ACDF: a retrospective cohort analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Radiographic subsidence after single-level anterior cervical discectomy and fusion; a comparison between blade-anchored zero-profile cages and stand-alone cages.Journal of orthopaedic surgery and research · 2026Article
- Hounsfield units as a predictor of cage subsidence and clinical outcomes following anterior cervical discectomy and fusion.Journal of spine surgery (Hong Kong) · 2026Article
- [Clinical efficacy of anterior cervical mortise-tenon corpectomy and fusion for the treatment of ossification of the posterior longitudinal ligament].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Article
- First description of C5 pedicle subtraction osteotomy for post-ACDF kyphotic deformity: a case report.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Influence of cage material, plating and vertebral bone quality on subsidence and long-term outcomes following anterior cervical discectomy and fusion-a retrospective analysis.Journal of spine surgery (Hong Kong) · 2026Article
- Interbody cage subsidence after ACDF: a predictor of non-union and neck pain despite normal bone mineral density.Neurosurgical review · 2026Article
- A novel method of C-VBQ score and CT-HU as risk predictors for cage subsidence after short level ACDF.Scientific reports · 2026Article
- Development and validation of a nomogram prediction model for assessing cage subsidence risk following anterior cervical discectomy and fusion.BMC musculoskeletal disorders · 2026Article
- Comparison of multilevel anterior cervical discectomy and fusion utilizing zero-profile self-locking cages versus the cage-with-plate system: a 5-year-minimum follow-up study.Asian spine journal · 2026Article
- Impact of cage type on subsidence following anterior cervical discectomy and fusion: a retrospective study.Asian spine journal · 2026Article
- Radiological Factors Affecting Cage Subsidence after Single-level Anterior Cervical Discectomy and Fusion with Double Titanium Cylindrical Cages.Neurologia medico-chirurgica · 2026Article
22 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 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.
aimTo assess the incidence and relevance of subsidence.
methodsLiterature 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.
resultsSeventy-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). Thirteen studies assessed clinical outcome in relation to subsidence; the majority did not find a significant correlation. Only four studies correlated subsidence to cage size and/or height; no correlation was established.
conclusionsSubsidence in ACDF with cages occurs in 21% of patients. The risk for subsidence seems lower using PEEK or titanium cages or adding screws. Whether subsidence affects clinical outcome is not satisfactorily evaluated in the available literature. Future studies on this correlation are warranted in order to establish the additional value of the interposition of a cage in ACDF.
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