Safety and Efficacy of Anterior Cervical Corpectomy and Reconstruction With Expandable Cages for Treatment of Cervical Myelopathy-Focusing on Stand-Alone Cages: A Systematic Review and Meta-Analysis
Global Spine Journal, cilt.15, sa.7, ss.3439-3456, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 15 Sayı: 7
- Basım Tarihi: 2025
- Doi Numarası: 10.1177/21925682251334030
- Dergi Adı: Global Spine Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
- Sayfa Sayıları: ss.3439-3456
- Anahtar Kelimeler: corpectomy, stand-alone cages, myelopathy, expandable cages, cervical spine, meta-analysis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Study Design: Systematic review and Meta-analysis. Objectives: This study aims to evaluate the efficacy, postoperative outcomes, and potential complications of using expandable cages in cervical spine surgery. Methods: A comprehensive search was performed across Medline, Scopus, Web of Science, Cochrane, and Embase up to May 22, 2023. Meta-analyses and subgrouping analyses were performed using “OpenMetaAnalyst” and R software to analyze efficacy outcomes and complications. The assessment of heterogeneity utilized the i2and chi-squared tests, applying the random effect model. Results: Thirty studies were included, with 22 eligible for meta-analysis. The pooled data showed a significant improvement in the Cobb angle, Nurick’s score and modified Japanese Orthopedic Association (mJOA) score. The pooled stability rate post-surgery was 0.94 based on 7 studies, but the stand-alone cages showed a lower stability rate (0.83). Fusion rate showed high success at 0.94 across 14 studies but also the fusion rate in the stand-alone group was lower (0.89) with substantial heterogeneity (I2= 91.81%) suggests that stand-alone cages may not consistently achieve the same level of fusion as cages with anterior plating (fusion rate of 0.98, I2= 0%). Dysphagia was observed in 16% of patients, and hardware-related issues were reported in 9% of cases. Conclusions: expandable cages offer significant advantages in terms of fusion, stability, and neurological recovery. In particular, stand-alone expandable cages were associated with higher rates of complications, including dysphagia, subsidence, and hardware failure, compared to cages with anterior plating.