ArticleNorth American Spine Society journal2024
Anterior cervical decompression and fusion at one and two levels: trends and factors associated with structural allograft versus synthetic cages.
Article in North American Spine Society journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Construct length rather than interbody spacer material is associated with reoperation after anterior cervical discectomy and fusion.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Increased Odds of Perioperative Complications Following Lumbar Diskectomy Among Patients With a Colostomy.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Migraines as a Risk Factor for Many 90-Day Postoperative Complications Following Single-Level Anterior Cervical Diskectomy and Fusion.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Decrease in Pediatric Anterior Cruciate Ligament Injury-related Care Disparities for Medicaid Patients From 2015 to 2020.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Preoperative Anxiety: An Important Risk Factor of Postoperative Adverse Events and Increased Reoperation Rates in Patients Undergoing Single-Level Anterior Cervical Diskectomy and Fusion.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
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2 authors.
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Abstract
Background: Following decompression in anterior cervical discectomy and fusion (ACDF), reconstruction is typically done with structural allograft or a synthetic cage. Relative trends and factors associated with utilizing these implants have not been well characterized. Methods: The PearlDiver 2011 to 2021 M157 database was used to identify adult patients undergoing 1- or 2-level ACDF. The incidence of structural allograft versus synthetic cage utilized was compared by year. Patient factors predictive of synthetic cage use as the structural interbody for ACDF were assessed with multivariable analysis. Further, the use of anterior plates was trended to provide a measure of usage of stand-alone devices (this comparison was made beginning with 2016 based on coding limitations). Results: Of 173,833 isolated 1- or 2-level ACDF cases identified, structural allograft was used for 63,029 (36.3%) and synthetic cages were used for 110,804 (63.8%). The use of synthetic cages increased from 51.1% of cases in 2011 to 75.8% of cases in 2021 (p < 0.0001). Independent clinical predictors of synthetic cage use were: older age (odds ratio [OR] 1.02 per decade), female sex (OR 1.04), and greater ECI (OR 1.09 per 2-point increase).Independent non-clinical predictors of synthetic cage use were: geographic region (Northeast OR 1.11, South OR 1.85, and West 2.08, each relative to Midwest), and provider specialty (orthopedic OR 1.06 relative to neurosurgeons). There was an increase in the percent of synthetic cases without separately coded plate ("stand-alone" interbody cages: 21.7% in 2016 to 35.3% in 2021, p < 0.001). Conclusions: The usage of synthetic cages in 1- and 2- level ACDF has increased relative to structural allograft between 2011 and 2021 in the United States and more recently the use of "stand-alone" synthetic cages has been on the rise. Non-clinical as well as clinical factors were associated with implant choice, suggesting room for more consistent care algorithms.
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