Evidence map›Paper›PMID 41074956›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

A nationwide registry study of surgical and patient-reported outcomes following anterior cervical discectomy and fusion: Part 1 - Synthetic cages versus autologous crista bone grafts.

Victor Gabriel El-Hajj, Sruthi Ranganathan, Daniel de Wilde, Alec Jonason, Victor E Staartjes, Patrick Vigren, Elias Atallah, Erik Edström, Adrian Elmi-Terander

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In one paragraph

Article 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Swespine in the literature: a bibliometric analysis of trends and characteristics of publications.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 · 2026
    Review
  2. Article
  3. Observational
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

9 authors.

Victor Gabriel El-HajjDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Stockholm, Switzerland. victor.gabriel.elhajj@stud.ki.se.
Sruthi RanganathanDepartment of Medicine, University of Cambridge, Cambridge, Cambridge, UK.
Daniel de WildeMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Alec JonasonDepartment of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, Minneapolis, Minnesota, USA.
Victor E StaartjesDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Stockholm, Switzerland.
Patrick VigrenDepartment of Neurosurgery, Region Örebro County, Örebro University Hospital, Örebro, Örebro, Sweden.
Elias AtallahDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, Philadelphia, Pennsylvania, USA.
Erik EdströmDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Stockholm, Switzerland.
Adrian Elmi-TeranderDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Stockholm, Switzerland. adrian.elmi.terander@ki.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAnterior cervical discectomy and fusion (ACDF) is one of the most common spinal procedures performed. The choice of fusion material for ACDF is crucial due to its influence on surgical outcomes and patient-reported outcome measures (PROM). While previous studies have evaluated radiological and perioperative outcomes, limited evidence exists on the impact of fusion materials on PROMs. This study aims to compare conventional surgical outcomes and PROMs between patients receiving synthetic cages and autologous crista grafts.

methodsThis nationwide observational study utilized data from the Swedish Spine Registry (Swespine). All adults who underwent ACDF between 2006 and 2020 were eligible for inclusion. Patients with missing baseline or outcome data were excluded. Propensity score matching at a 2:1 ratio was performed to adjust for baseline differences.

results7,716 patients were included, with 92% (n = 7,107) receiving synthetic cages and 8% receiving autologous crista bone grafts (n = 609). After matching, the synthetic cage group showed significantly lower complication (1.6% vs. 3.1%, p = 0.028) and reoperation rates (2.5% vs. 4.6%, p = 0.014), and shorter hospital stays (2.14 ± 1.98 vs. 2.89 ± 2.05, p < 0.001). PROMs at 1-year follow-up revealed no significant differences in neck and arm pain (Numerical Rating Scale (NRS) scores), Neck Disability Index (NDI), European myelopathy score, or quality of life (EQ-5D, EQ-VAS). Satisfaction rates were comparable (74% vs. 72%, p = 0.72).

conclusionIn this matched analysis, synthetic interbody fusion cages were comparable to autologous crista bone grafts for ACDF, with no significant differences in PROMs at 1-year follow-up. However, synthetic cages were associated with lower complication rates, reoperation rates, and shorter hospital stays.

Indexed as

Bone transplantationDiskectomyPatient reported outcome measuresRegistriesSpinal fusion

Identifiers

PMID41074956

What OpenQuestion holds

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Registered trials

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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.