Background Anterior cervical discectomy and fusion (ACDF) is a successful strategy to relieve the symptoms caused by cervical degenerative disease. Postoperative dysphagia is one complication of this kind of surgery. We performed this study to compare the clinical outcomes, radiographic parameters, and complications of ACDF with a Zero-profile implant (Zero-P) and titanium plate and cage.
Methods There were 68 patients received ACDF of single level, 35 patients with Zero-profile implant (Zero-p group) and 33 patients with traditional plate and cage (Cage group), from C3–C7 during 2014 to 2016. Collecting and analyzing of clinical and radiological data were performed. Patients were followed-up at least 1 year after surgery. The operation time, blood loss, Japan Department of Orthopedics Association (JOA) score, pain Visual Analogue Score (VAS), Neck Disability Index (NDI) score and dysphagia score were recorded. Additionally, changes in cervical lordosis, fusion rate and adjacent segment degeneration were analyzed as well.
Results For neurologic outcomes, the JOA, VAS and NDI were statistically equivalent between the two groups (P>0.05). For radiographic outcomes, there were no significant differences in the C2-7 Cobb angles, segmental Cobb angle and incidence of subsidence at the final follow-up (P>0.05). No degenerative changes was found in the Zero-p group, whereas 5 patients in the Cage group developed degeneration in adjacent segments (P<0.05). Also, the incidence of postoperative dysphagia is higher in Cage group than in Zero-p group at 3 months and 12 months (P<0.05).
Conclusions Both Zero-profile implant and anterior cervical plate interbody fusion device were demonstrated to be effective and safe strategies in this study. Considering the lower incidences of dysphagia and degenerative changes, the Zero-profile implant is a good succedaneum.