Comparison of Zero-profile Device versus Plate and Cage Implant in the Treatment of Symptomatic Adjacent Segment Disease after Anterior Cervical Discectomy and Fusion.

Comparison of Zero-profile Device versus Plate and Cage Implant in the Treatment of Symptomatic Adjacent Segment Disease after Anterior Cervical Discectomy and Fusion.

World Neurosurg. 2018 Apr 11;:

Authors: Shen Y, Du W, Wang LF, Dong Z, Wang F

Abstract
OBJECTIVE: The purpose of this study was to compare the clinical efficacy of ACDF with Zero-profile device (Zero-p) and traditional cervical plate and cage implant in the treatment of symptomatic ASD and determine the optimal reoperation procedure.
METHODS: This was a retrospective study of 58 patients with symptomatic ASD after an initial ACDF surgery, which had undergone a reoperation by ACDF with Zero-p (n=27) and cervical plate and cage (n=31) at our medical center between January 2010 and December 2015.
RESULTS: The JOA score, NDI score, VAS score, C2-C7 Cobb angle and DHI demonstrated significant improvements compared with the preoperative in both Zero-p and plate and cage groups (P<0.05). However, there were no differences between the two groups (P>0.05). The reoperation time of Zero-p group [(83.4±18.9) min] was less than plate and cage group [(96.5±20.1) min], with significant differences (P<0.05). A total of 5 (8.6%) patients had cage subsidence and 14 (24.1%) patients had dysphagia after the reoperation. There was no statistical significance in the difference between two groups in cage subsidence (P>0.05). However, the incidence of dysphagia in plate and cage group (38.7%) was higher than Zero-p group (7.4%), with significant difference (P<0.05).
CONCLUSION: ACDF with Zero-p obtaining the same surgical efficacy, compared with traditional cervical plate and cage can significantly shorten the reoperation time, and reduce the incidence of postoperative dysphagia. It may be a preferred option for symptomatic ASD patients qualifying for the anterior approach with regard to biomechanics and surgical outcomes.

PMID: 29654956 [PubMed - as supplied by publisher]

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