Anterior cervical discectomy & fusion using only cage: An institutional experiences

Background: Anterior Cervical Discectomy and Fusion (ACDF) using a standalone cage represents a pivotal advancement in the surgical management of cervical degenerative disc disease. This study evaluates the efficacy, safety, and clinical outcomes of ACDF performed with a standalone cage without using plate, aiming to substantiate its utility in clinical practice. Materials and Methods: A retrospective analysis of 440 patients who underwent ACDF with a standalone cage from 2013 to 2023 was conducted at Neuro Care Hospital and Research Centre in Jaipur, India. Clinical outcomes were assessed using the Nurick grade, Visual Analog Scale (VAS) for neck and arm pain, and the Modified Japanese Orthopedic Association (mJOA) scoring system at the 6-month follow-up. Complications were also recorded. Results: Significant improvements were observed postoperatively: Nurick grade improved from 1.46 ± 0.90 to 0.40 ± 0.59 (p<0.001), neck VAS scores from 4.04 ± 0.77 to 1.66 ± 0.93, and arm VAS scores from 7.25 ± 1.19 to 1.63 ± 0.86 (both p<0.001). The mJOA score enhanced from 11.6 ± 1.42 to 15.9 ± 1.76 (p<0.001). Complication rates were low, with cage subsidence being the most notable. Conclusion: ACDF with a standalone cage is effective and safe, significantly improving patient outcomes at 6 months post-surgery with minimal complications, thereby supporting its application as a standard procedure for cervical degenerative disc disease.