Comparison of Radiological and Clinical Outcomes between Expandable and Non-expandable Cages Following Cervical Corpectomy: A Systematic Review and Meta-analysis br

Anterior Cervical corpectomy and fusion is considered the mainstay of surgical treatment in cervical pathology. Expandable and non- expandable cages are preferred over autogenous bone graft because of donor-related morbidity. However, the choice of the cage type remains debatable topic as studies report conflicting results. Thus, we evaluated the outcomes of expandable and non-expandable cages following cervical corpectomy. Studies were searched in various electronic databases (MEDLINE, PubMed, EMBASE, CINAHL,<br />Scopus, and Cochrane between 201 and 202T. Forest plot was made to compare the radiological and clinical outcomes between ex- pandable and non-expandable cages following cervical corpectomy. Altogether, 26 studies (1,170 patients) were included in the meta- analysis. The mean change in segmental angle was significantly greater in the expandable cage group than in the non-expandable cage group (6.7 vs. 3.0 degrees, p<0.001). The mean subsidence rate was lower in the expandable cage group (6% vs. 41%, p<0.001). The mean fusion rate was lower (93% vs. 98%, p=0.06) and the mean displacement rate was significantly higher in the expandable cage group (29% vs. 5%, p<0.05). The mean reoperation rate was higher in the expandable cage group (16% vs. 2%, p>0.05). The improve- ment in segmental angle is better with expandable cages. Higher subsidence is a major problem with non-expandable cages, but it seems to be beneficial as evidenced by the high fusion rate and minimal effect on clinical outcome in patients with this cage.