Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

Abstract

ObjectiveThis study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices.MethodsWe retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively.ResultsThe Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group.ConclusionsApplication of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up

“…Although the pathogenesis of the dysphagia is yet to be precisely known, it has been reported that the zero-profile designed stand-alone cage may effectively reduce the incidence of long-term dysphagia without irritation of implants which were directly placed posterior to the esophagus [2,24]. In addition, some authors suggest that post-operative dysphagia may be caused by direct trauma to the esophagus and its surrounding tissue during the surgery [2,25]. The selflocking stand-alone cage can make the operative procedure simpler with less retraction of the esophageal.…”

“…Dysphagia is common after anterior cervical spine surgery especially in the multi-level ACDF [11,24,25]. Although the pathogenesis of the dysphagia is yet to be precisely known, it has been reported that the zero-profile designed stand-alone cage may effectively reduce the incidence of long-term dysphagia without irritation of implants which were directly placed posterior to the esophagus [2,24].…”

A Matched Cohort Analysis Comparing Stand-Alone Cages and Anterior Cervical Plates Used for Anterior Cervical Discectomy and Fusion

“…Many studies have shown equivalent radiographic and clinical results as well as a lower incidence of postoperative dysphagia. 24 - 30 However, no study has directly compared the 2 groups with regard to length of stay, ambulatory versus inpatient status, and overall complication profiles, leading many skeptics to question the safety of stand-alone cages.…”

Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion

“…The authors observed that, at the final follow-up, dysphagia rate was significantly lower in the group of PEEK-titanium combined anchored cage (0.4%, 1 of 266) as compared to the group of anterior cervical cage-plate (6.7%, 20 of 300) (p=0.01)14). Similarly, Son et al23) also reported that the dysphagia rate 6 months after ACDF using anterior cervical plate was 22.2% as compared with PEEK-titanium combined anchored cage (0%) (p=0.02).…”