Our Summary

This study looks at two different types of devices used in a type of neck surgery called anterior cervical discectomy and fusion (ACDF). The two devices are stand-alone anchored spacers (SAAS) and cage-plate systems (CPS). The researchers wanted to find out which device is more effective and safer to use in the long-term for this surgery when it’s done on multiple levels of the neck.

To do this, they examined and compared results from nine different studies that included a total of 584 patients. They found that using SAAS resulted in less time in surgery, less blood loss during surgery, and less difficulty swallowing after surgery compared to using CPS. However, the SAAS device resulted in some changes in neck alignment and the height of the fused area, and there was a higher chance of the device sinking into the bone over time compared to CPS.

In terms of long-term outcomes, like function and health of the neck, pain, fusion of the bones, and degeneration of the segments next to the surgery site, there was no difference between the two devices.

Overall, SAAS appears to be better than CPS for people needing this surgery on multiple levels of their neck, as it reduces surgery time, blood loss and swallowing difficulties post-surgery. But, it’s not as good as CPS at maintaining the alignment and height of the fused area and preventing the device from sinking into the bone over time. The study suggests more research is needed to see if these physical changes seen on x-rays actually affect patients’ symptoms or function in the long term.

FAQs

  1. What are the two devices used in anterior cervical discectomy and fusion (ACDF)?
  2. What are the advantages and disadvantages of using the stand-alone anchored spacers (SAAS) device in ACDF surgery?
  3. Was there any difference between the two devices in terms of long-term outcomes like function and health of the neck, pain, fusion of the bones, and degeneration of the segments next to the surgery site?

Doctor’s Tip

A doctor may advise a patient undergoing discectomy to discuss with them the different types of devices that can be used in the surgery, such as stand-alone anchored spacers (SAAS) versus cage-plate systems (CPS). They may explain that while SAAS may result in less time in surgery, less blood loss, and less difficulty swallowing post-surgery, it may also lead to changes in neck alignment and a higher risk of device sinking into the bone over time. On the other hand, CPS may be better at maintaining alignment and preventing device sinking, but there may be no significant difference in long-term outcomes between the two devices. The doctor may recommend choosing the device based on individual needs and priorities, and emphasize the importance of discussing all options and potential risks with the surgeon before making a decision.

Suitable For

Patients who are typically recommended for discectomy are those who have symptoms related to a herniated disc in the neck, such as neck pain, arm pain, numbness, weakness, or tingling. Discectomy is often recommended when conservative treatments like physical therapy, medication, and injections have not provided relief. Patients who have tried these treatments for at least 6 weeks without improvement may be considered for discectomy.

Additionally, patients who have significant nerve compression or spinal cord compression due to a herniated disc may also be recommended for discectomy. This surgery can help alleviate pressure on the nerves or spinal cord, reduce pain, and improve function in the affected area.

It’s important for patients to discuss with their healthcare provider to determine if discectomy is the right treatment option for their specific condition and symptoms.

Timeline

Before discectomy surgery, a patient typically experiences symptoms such as neck or arm pain, numbness, weakness, and difficulty with fine motor skills. They may undergo imaging tests such as X-rays, MRI, or CT scans to determine the source of their symptoms. They may also undergo conservative treatments such as physical therapy, medications, and injections to manage their symptoms.

After discectomy surgery, the patient will likely experience some pain and discomfort at the surgical site. They may need to stay in the hospital for a day or two for monitoring and pain management. They will be prescribed pain medications and instructed on how to care for their incision site. Physical therapy may be recommended to help improve strength and range of motion in the neck. Over time, the patient should experience a reduction in their symptoms and improved function in the affected area. Follow-up appointments with the surgeon will be scheduled to monitor progress and address any concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy procedure?
  2. How long is the recovery process after a discectomy surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. How successful is the surgery in relieving pain and improving function in the long term?
  5. Are there any alternative treatments or procedures that could be considered instead of a discectomy?
  6. How many levels of my neck will need to be operated on, and how does this impact the choice between SAAS and CPS devices?
  7. What are the specific differences between SAAS and CPS devices in terms of their long-term effects on the neck?
  8. How likely is it that the device used during surgery will sink into the bone over time, and what are the implications of this?
  9. Will I need additional surgeries or treatments in the future after having a discectomy with either the SAAS or CPS device?
  10. What is the overall success rate of using SAAS or CPS devices in patients undergoing discectomy surgery on multiple levels of the neck?

Reference

Authors: Zhang Y, Ju J, Wu J. Journal: Eur Spine J. 2025 Feb;34(2):694-706. doi: 10.1007/s00586-024-08613-y. Epub 2024 Dec 19. PMID: 39694916