Zero-profile spacer versus cage-plate construct in anterior cervical discectomy and fusion for multilevel cervical spondylotic myelopathy: A systematic review and meta-analysis.

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Zero-profile spacer versus cage-plate construct in anterior cervical discectomy and fusion for multilevel cervical spondylotic myelopathy: A systematic review and meta-analysis.

World Neurosurg. 2017 May 16;:

Authors: Tong MJ, Xiang GH, He ZL, Chen DH, Tang Q, Xu HZ, Tian NF

Abstract
BACKGROUD: Anterior cervical discectomy and fusion (ACDF) with plate-screw construct has been gradually applied for multilevel cervical spondylotic myelopathy (CSM) in recent years. However, long cervical plate was associated with complications including breakage or loosening of plate and screws, trachea-esophageal injury, neurovascular injury, and postoperative dysphagia. To reduce these complications, the zero-profile spacer has been introduced. This meta-analysis was performed to compared the clinical and radiological outcomes of zero-profile spacer versus cage-plate construct for the treatment of multilevel cervical spondylotic myelopathy.
METHODS: We systematically searched MEDLINE, Springer, and Web of science databases for relevant studies that compared the clinical and radiological outcomes of zero-profile spacer versus cage and plate for multilevel cervical spondylotic myelopathy. Risk of bias in included studies was assessed. Pooled estimates and corresponding 95 % confidence intervals were calculated.
RESULTS: Based on predefined inclusion criteria, seven studies with a total of 409 patients were included in this analysis. The pooled data revealed that zero-profile spacer was associated with decreased dysphagia rate at 2, 3 and 6 months postoperatively when compared with cage-plate group. Both techniques had similar perioperative outcomes, functional outcome, radiological outcome, and dysphagia rate immediately and at over one-year after operation.
CONCLUSIONS: Based on available evidence, zero-profile spacer was more effective in reducing postoperative dysphagia rate for multilevel cervical spondylotic myelopathy. Both devices were safe in anterior cervical surgeries, and they had similar efficacy in improving the functional and radiological outcomes. More randomized controlled trials are needed to compare these two devices.

PMID: 28526640 [PubMed - as supplied by publisher]

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