Does Anterior Plating Improve Outcomes in ACDF? A Comparative Analysis of Cage-Only Versus Cage-with-Plating Techniques: A Comprehensive Meta-Analysis of Clinical and Radiological Outcomes

Background: Anterior cervical discectomy and fusion (ACDF) is a common operation done to address cervical disc issues. Whether cage-only or cage-with-plating methods should be used is still up for argument; some research indicates that plating could offer greater stability and enhance clinical results. However, the effect of plating on ACDF’s radiographic and clinical outcomes has not yet been proven. This study looks at how well cage-only and cage-with-plating methods work, both from a clinical and a radiological point of view. Methodology: A thorough search across several sources found 16 studies that fit the inclusion criteria. There were 1325 patients in total, 615 of whom had cage-only operations and 710 of whom had cage-with-plating procedures. The research encompassed observational, retrospective, and randomized controlled experiments. Meta-analysis methods were used to examine the combined data, contrasting the two surgical techniques across a number of clinical and radiological results. For each outcome, standardized mean differences (SMDs) and risk ratios (RRs) were determined. Results: Regarding cervical alignment (pre-operatively and post-operatively), segmental angle, or segmental height, both pre-operatively and post-operatively, the meta-analysis found no major differences between the two groups. Furthermore, the Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores showed no notable differences in clinical outcomes. Moreover, the cage-only and cage-with-plating groups did not differ notably in terms of subsidence, adjacent segment disease (ASD), and fusion rates. Conclusion: In ACDF, cage-only treatments have no appreciable advantages over cage-with-plating methods in terms of clinical or radiological results, according to this meta-analysis. In terms of cervical alignment, segmental stability, clinical recovery, and long-term consequences, both techniques yield somewhat similar outcomes. These results imply that the best outcomes in ACDF might not require plating, hence promoting cage-only techniques as a successful and perhaps less intrusive alternative.