~ 775 ~ International Journal of Orthopaedics Sciences 2018; 4(4): 775-781 ISSN: 2395-1958 IJOS 2018; 4(4): 775-781 © 2018 IJOS www.orthopaper.com Received: 26-08-2018 Accepted: 30-09-2018 Dr. Arvind B Goregaonkar Professor & Head, Dept. of Orthopaedics, LTMGH, Sion, Mumbai, Maharashtra, India Dr. Rajesh Srinivas Registrar, LTMGH, Sion, Mumbai, Maharashtra, India Dr. Hitesh Shukla Registrar, LTMGH, Sion, Mumbai, Maharashtra, India Dr. Jitesh Mangwani Registrar, LTMGH, Sion, Mumbai, India Dr. Amit Singh Registrar, LTMGH, Sion, Mumbai, Maharashtra, India Dr. Santosh Bindumadhavan Registrar, LTMGH, Sion, Mumbai, Maharashtra, India Correspondence Dr. Rajesh Srinivas Registrar, LTMGH, Sion, Mumbai, Maharashtra, India Clinico- radiological evaluation of stand alone cage in degenerative cervical spine Dr. Arvind B Goregaonkar, Dr. Rajesh Srinivas, Dr. Hitesh Shukla, Dr. Jitesh Mangwani, Dr. Amit Singh and Dr. Santosh Bindumadhavan DOI: https://doi.org/10.22271/ortho.2018.v4.i4j.100 Abstract Age-related cervical degeneration is evident in over 50% of the middle-aged population and is the most common cause of neural dysfunction. Cervical spine anteriorly stabilised by use of anterior cervical plate, strut graft, standalone cage or combination to maintain curvature and facilitate arthrodesis. Standalone strut graft has high rate of complications such as graft subsidence, dislodgement, non-union and donor site morbidities. Anterior plating has inherent deficiencies like plate loosening, screw pull out, breakage, trachea-oesophagal irritation has increased operation time. Intervertebral cages avoid some of these difficulties due to their self-fixing construct, ability to contain graft or graft substitute in it. The aim of this study is to compare the clinical and radiological outcome of stand alone cage in single level anterior cervical discectomy and fusion used to treat cervical degenerative disc disease. We performed a prospective study of 30 patients treated with stand alone -cage in single level cervical disc disease. The clinical and radiological outcomes were evaluated which includes visual analogue scale, Japanese orthopaedic association, neck disability index, neurological status, cobbs angle, fusion and subsidence. Through Smith-Robbinson approach ACDF was done. Patients were assessed up. There is a significant improvement of symptoms reflected by VAS score for pain and functional scores like JOA and NDI. Bony fusion was achieved in 29 patients with a rate of 96.7%. Cervical spine alignment was restored in all patients with kyphosis occurring in 23.3% of patients. Cage subsidence rate was 26.7% with majority occurring in C5-6 level. Anterior cervical discectomy and inter body fusion using stand alone cervical cages can be considered a safe and equally efficient alternative to iliac crest auto graft and anterior cervical plating by providing adequate stability. Stand-alone cage can restore physiologic disc height, provide immediate load bearing support to the anterior column and facilitate arthrodesis. Keywords: anterior cervical discectomy and fusion, japanese orthopaedic association Introduction Spondylosis refers to these age-related degenerative changes within the spinal column. Although the majority of cases are asymptomatic, changes such as disc herniation, osteophyte formation, and hypertrophied ligaments may compress the cervical neuraxis to result in neck pain, radiculopathy, or myelopathy [1] . Several procedures have been described for the treatment of disc herniation and cervical spondylosis when conservative treatment fails, including anterior decompression, laminectomy, laminoplasty and instrumented anterior and posterior fusion by plates or screws. After anterior cervical discectomy, intervertebral fusion can be facilitated by using autograft (Iliac crest, fibula), allograft or bone graft substitutes. Standalone strut graft has high rate of complications such as graft subsidence, dislodgement, non-union and donor site morbidities. Anterior plating has inherent deficiencies like plate loosening, screw pullout, breakage, trachea-oesophagal irritation has increased operation time [2, 3] . Intervertebral cages have been postulated to avoid some of these difficulties due to their self- fixing construct, ability to contain graft or graft substitute in it. Stand-alone interbody fusion cages represent an alternative for anterior cervical fusion in the treatment of cervical degenerative disc disease. The reason for development of similar fusion device was the