A New Stand-Alone Cervical Anterior Interbody Fusion Device

Scholz, Matti; Reyes, Phillip M.; Schleicher, Philipp; Sawa, Anna G.U.; Baek, Seungwon; Kandziora, Frank; Marciano, Frederick F.; Crawford, Neil R.

doi:10.1097/brs.0b013e31818ff9c4

Cited by 106 publications

(52 citation statements)

References 12 publications

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“…However, several postoperative complications are closely associated with the anterior plate, as the plate can lead to the compression or stimulation of vital structures[27]. Zero-P is a stand-alone anchored spacer designed to reduce the profile of the anterior plate in cervical fusion and to simultaneously provide the spine a stable biomechanical environment[12, 13]. Several relevant clinical studies have compared Zero-P and anterior plate techniques following ACDF[16–20, 24–28]; however, the evidence regarding whether Zero-P is superior to anterior plate is insufficient.…”

Section: Discussionmentioning

confidence: 99%

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Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion

et al. 2015

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BackgroundAnterior plate fusion is an effective procedure for the treatment of cervical spinal diseases but is accompanied by a high incidence of postoperative dysphagia. A zero profile (Zero-P) spacer is increasingly being used to reduce postoperative dysphagia and other potential complications associated with surgical intervention. Studies comparing the Zero-P spacer and anterior plate have reported conflicting results.MethodologyA meta-analysis was conducted to compare the safety, efficacy, radiological outcomes and complications associated with the use of a Zero-P spacer versus an anterior plate in anterior cervical spine fusion for the treatment of cervical spinal disease. We comprehensively searched PubMed, Embase, the Cochrane Library and other databases and performed a meta-analysis of all randomized controlled trials (RCTs) and prospective or retrospective comparative studies assessing the two techniques.ResultsTen studies enrolling 719 cervical spondylosis patients were included. The pooled data showed significant differences in the operation time [SMD = –0.58 (95% CI = −0.77 to 0.40, p < 0.01)] and blood loss [SMD = −0.40, 95% CI (−0.59 to –0.21), p < 0.01] between the two groups. Compared to the anterior plate group, the Zero-P group exhibited a significantly improved JOA score and reduced NDI and VAS. However, anterior plate fusion had greater postoperative segmental and cervical Cobb’s angles than the Zero-P group at the last follow-up. The fusion rate in the two groups was similar. More importantly, the Zero-P group had a lower incidence of earlier and later postoperative dysphagia.ConclusionsCompared to anterior plate fusion, Zero-P is a safer and effective procedure, with a similar fusion rate and lower incidence of earlier and later postoperative dysphagia. However, the results of this meta-analysis should be accepted with caution due to the limitations of the study. Further evaluation and large-sample RCTs are required to confirm and update the results of this study.

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Section: Discussionmentioning

confidence: 99%

“…Biomechanical testing of Zero-P has demonstrated similar stability when compared with the anterior plate[12, 13]. This device contains an interbody spacer and a rigid, very low-profile plate for the screw fixation in the interbody interval instead of the anterior space of the cervical vertebral body.…”

Section: Introductionmentioning

confidence: 99%

Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion

et al. 2015

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“…These problems have led to the need for self-locking standalone cervical cages which do not require anterior cervical plating and are thought to have overcome the previous complications. The stand-alone cage has been used widely in clinical practice, and successful clinical results have been reported in more than one study (14,27). Until now, the literature is lacking of studies examining the quality of life after ACDF with the use of these cages.…”

Section: Discussionmentioning

confidence: 99%

“…Stand-alone cervical anterior interbody fusion devices have already been used (27). All patients were monitored in terms of blood pressure, pulse rate, oxygen saturation and electrocardiographic signals.…”

Section: Surgical Methodsmentioning

confidence: 99%

Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

Kapetanakis¹,

Thomaidis²,

Charitoudis³

et al. 2017

J. Spine Surg.

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Background: Anterior cervical discectomy and fusion (ACDF) constitutes the conventional treatment of cervical disc herniation due to degenerative disc disease (DDD). ACDF with plating presents a variety of complications postoperatively and stand-alone cages are thought to be a promising alternative. The aim of this study was firstly, to analyze prospectively collected data from a sample of patients treated with single ACDF using C-Plus self-locking stand-alone PEEK cage system, without the use of plates or screws, in order to evaluate pain levels of patients, utilizing Neck and Arm Pain scale as an expression of visual analogue scale (VAS). Secondly, we aimed to evaluate health-related quality of life, via the short-form 36 (SF-36) and Neck Disability Index (NDI).Methods: Thirty-six patients (19 male and 17 female) with mean age 49.6±7 years old who underwent successful single ACDF using self-locking stand-alone PEEK cage for symptomatic cervical DDD were selected for the study. Neck and Arm pain, as well as SF-36 and NDI were estimated preoperatively and 1, 3, 6, and 12 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological and radiological evaluation. Results:The clinical and radiological outcomes were satisfactory after a minimum 1-year follow-up.All results were statistically important (P<0.05), excluding improvement in NDI measured between 6 and 12 months. SF-36, Neck Pain, as well as Arm Pain featured gradual and constant improvement during follow-up, with best scores presenting at 12 months after surgery, while NDI reached its best at 6 months postoperatively.Conclusions: Generally, all scores showed improvement postoperatively during the different phases of the follow-up. Subsequently, ACDF using C-Plus cervical cage constitutes an effective method for cervical disc herniation treatment, in terms of postoperative improvement on pain levels and health-related quality of life and a safe alternative to the conventional method of treatment for cervical DDD.

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“…This "anchored spacer" consists of a PEEK interbody cage with a ventral titanium housing that allows for anchoring screws to be placed diagonally into the adjacent vertebral bodies. Scholz et al [51,50] recently examined the biomechanical properties of this stand-alone cervical interbody device. This device demonstrated decreased range of motion compared to interbody cage alone (no fixation) and no significant difference when compared to the addition of a locking or dynamic anterior cervical plate.…”

Section: Anterior Platingmentioning

confidence: 99%

Anterior Surgical Treatment of Cervical Spondylotic Myelopathy

Quinn

Kiely

Lebl

et al. 2015

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Cervical spondylotic myelopathy (CSM) is a common indication for cervical spine surgery. Surgical options include anterior, posterior, or combined procedures each with specific advantages and disadvantages. Questions/Purposes: This article will provide a description of the various anterior alternatives and discuss the available evidence used in guiding the surgical decision making process with the aim of answering the following questions: (1) What anatomical/disease related factors favor anterior over posterior surgeries? (2) What are the common anterior procedures and how safe and effective are they? (3) What are the most effective options for multilevel CSM? (4) Is there a role for motion preservation? An additional objective is to discuss technical advances that have improved success rates for anterior procedures. Methods: The PubMed database was searched. Keywords were CSM and anterior surgery. Three hundred eighty two articles were found one hundred three were reviewed. Articles describing anterior cervical techniques were selected along with studies describing the various anterior techniques or comparisons of anterior to posterior techniques. Results: Anterior decompression and fusion procedures are more effective than posterior procedures for patients with primarily ventrally located compression especially in the presence of cervical kyphosis. ACDF, ACCF, and hybrid combinations are safe and effective treatment options for multilevel CSM. Anterior procedures may be more cost effective and result in significantly improved postoperative quality of life and health-related quality of life measures compared to posterior procedures. Conclusion: Anterior cervical decompression techniques are safe and effective in the treatment of CSM. Anterior surgeries may be preferable to posterior approaches, when considering health-related quality of life measures and cost effectiveness.

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A New Stand-Alone Cervical Anterior Interbody Fusion Device

Cited by 106 publications

References 12 publications

Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion

Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion

Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

Anterior Surgical Treatment of Cervical Spondylotic Myelopathy

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