Standalone cages versus plate-augmented fusion in multilevel anterior cervical discectomy and fusion: A 12-month prospective study balancing clinical equivalence and radiological superiority

While standalone cages achieve comparable short-term symptom relief, plate augmentation offers superior radiological stability in multilevel ACDF, preserving alignment and optimizing fusion success without increasing perioperative risks. These findings support selective plate use in complex, multilevel constructs while affirming standalone cages as a viable option for patients with contraindications to plating. This study refines evidence-based decision-making in cervical spine surgery, balancing innovation with biomechanical rigor.