Anterior Interbody Fusion of the Cervical Spine With Zero-P Spacer

Vaněk, Petr; Bradáč, Ondřej; deLacy, Patricia; Lacman, J.; Beneš, Vladimı́r

doi:10.1097/brs.0b013e3182913400

Cited by 60 publications

(36 citation statements)

References 20 publications

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“…Four studies consisting of 381 patients reported the preoperative and postoperative neck NDI (Zero-P group, 180; Plate group, 201)[17, 19, 20, 27]. The fixed-effects model was applied to compare the preoperative or postoperative NDI between the two groups but was accompanied by high heterogeneity (preoperative, I 2 = 94%; postoperative, I 2 = 84%).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies reported a postoperative segmental Cobb’s angle in 163 patients (Zero-P group, 88; Plate group, 75)[16, 26, 27]. The fixed-effects model was applied to compare the postoperative segmental Cobb’s angle between the two groups.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies consisting of 556 patients reported postoperative cervical Cobb’s angle (Zero-P group, 263; Plate group, 293)[16, 17, 19, 20, 25–27]. The heterogeneity in comparing the postoperative cervical Cobb’s angle between the two groups was significant in the fixed-effects model (I 2 = 86%).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies consisting of 237 patients reported the fusion rate at the end of follow-up (Zero-P group, 121; Plate group, 116)[16, 17, 20, 27]. The fixed-effects model was applied to compare dysphagia rate at the end of follow-up between the two groups.…”

Section: Resultsmentioning

confidence: 99%

“…During this procedure, an anterior cervical plate is usually applied to enhance the cervical stability, increase the interbody fusion rate and prevent graft dislocation or subsidence[3, 29]. 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].…”

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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