Evidence map›Paper›PMID 39694916›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

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.

Yu Zhang, Jidong Ju, Jinchun Wu

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Yu ZhangDepartment of Orthopaedics, Jingjiang People's Hospital Affiliated to Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China.ORCID 0000-0003-0397-8955
Jidong JuDepartment of Orthopaedics, Jingjiang People's Hospital Affiliated to Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China.
Jinchun WuDepartment of Orthopaedics, Jingjiang People's Hospital Affiliated to Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China. 13961032255@yzu.edu.cn.ORCID 0009-0006-4646-5374

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveFor anterior cervical discectomy and fusion (ACDF), stand-alone anchored spacers (SAAS) and cage-plate system (CPS) are currently employed. However, controversy remains over the effectiveness and security of these two apparatuses in multilevel ACDF. The aim of this study was to demonstrate the global long-term effectiveness and safety of SAAS versus CPS with multilevel ACDF.

methodsWe conducted a systematic review of studies comparing SAAS with CPS for multilevel ACDF using four electronic databases. Data from this meta-analysis were analyzed with Stata MP 17.0.

resultsA total of nine trials comprising 584 patients were selected for inclusion. SAAS significantly reduced operative time, intraoperative bleeding and the incidence of postoperative dysphagia compared with CPS. The SAAS group exhibited significantly smaller cervical sagittal angle (CSA) and fusion segmental height (FSH) compared to CPS group. At final follow-up, the rate of cage sinking was higher in SAAS group compared to CPS group. At the endpoint, there was no difference in JOA score, NDI score, fusion rate or the incidence of adjacent segment degeneration (ASD).

conclusionsSAAS provided comparable long-term effectiveness and safeness for multilevel ACDF regarding JOA scores, NDI scores, fusion rates and ASD rates at endpoint compared to CPS. In comparison to CPS, SAAS demonstrated significant advancement in the reduction of operative time, intraoperative blood loss and the incidence of postoperative dysphagia. As a consequence, SAAS appeared more desirable than CPS among people who needed multilevel ACDF. Yet in long-term observation, SAAS was inferior to CPS in maintaining CSA and FSH and in preventing cage descent. However, whether or not radiographic abnormality has an impact on clinical presentation awaits confirmation from research with more longitudinal follow-up.

Indexed as

Bone PlatesCervical VertebraeDiskectomySpinal FusionHumansPostoperative ComplicationsTreatment OutcomeAnterior cervical discectomy and fusionCage-plate systemLong-term efficacy and safetyMultilevelStand-alone anchored spacer

Identifiers

PMID39694916

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.