Clinical results of using Cage only versus Cage with plate fixation in treating multiple-level cervical spondylosis

[Objective]To research if anterior cervical plate fixation is needed after multiple-level anterior cervical decompression and fusion with cage. [Methods]Seventy-two patients suffered from multiple-level cervical spondylosis which were treated surgically with anterior cervical decompression and fusion form April 2003 to October 2010 were reviewed.According to the operation method,all cases were divided into 2 groups: group A,32 cases were treated surgically with anterior cervical decompression and fusion with Cage(ACDF-CA),group B,40 cases were treated surgically with anterior cervical discectomy and fusion with Cage and anterior cervical plate fixation(ACDF-CPA).The clinical and radiography results of the two groups were compared. [Results]The amount of blood loss between two groups was not statistically significant(P0.05),the operation time and radioactive exposure time of group A was longer than in group B(P0.05).The symptom alleviation rate and the cervical fusion rate were not statistically significant(P0.05) between two groups.The cervical physiology lordosis(value of D)after operation between two groups improved significantly(P0.01).The lost degree of cervical physiology lordosis in group A was greater than in group B(P0.01)after following up of one year.The height of intervertebral gap after operation between two groups improved significantly(P0.01).The lost degree of height of intervertebral gap in group A was greater than in group B(P0.01) after following up of one year. [Conclusion]Multiple-level ACDF-CA and ACDF-CPA are safe and effective.Anterior cervical plate fixation helps to promot early fusion,prevent the collapse of intervertebral gap,keep the height of intervertebral space and cervical physiology lordosis.