Biomechanical evaluation comparing zero-profile devices versus fixed profile systems in a cervical hybrid decompression model: a biomechanical in vitro study

Kinon, Merritt D.; Greeley, Samantha; Harris, Jonathan; Gelfand, Yaroslav; Yassari, Reza; Nakhla, Jonathan; Ramos, Rafael De la Garza; Patel, Pavan D.; Mirabile, Belin A; Bucklen, Brandon

doi:10.1016/j.spinee.2019.10.004

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…4 Forest plot of ASD between the ZP group and CP group in follow-up time, the difference between the two groups was more obvious. Although the exact pathophysiologic mechanism of LOC remains unclear, according to Kinon et al [26], plate could combine all vertebrae and instruments work as a whole, by working as a frame resisting axial compression, especially with screws on multilevel vertebrae. Meanwhile, biomechanical research works found that the plate could provide better segmental stability than Zero-profile spacer [27,28], which was consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

et al. 2022

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Background Anterior cervical diskectomy and fusion (ACDF) has been widely accepted as a gold standard for patients with cervical spondylotic myelopathy (CSM). However, there was insufficient evidence to compare the changes in the cervical alignment with different fusion devices in a long follow-up period. This meta-analysis was performed to compare the radiologic outcomes and loss of correction (LOC) in cervical alignment of Zero-profile (ZP) device versus cage-plate (CP) construct for the treatment of CSM. Methods Retrospective and prospective studies directly comparing the outcomes between the ZP device and CP construct in ACDF were included. Data extraction was conducted and study quality was assessed independently. A meta-analysis was carried out by using fixed effects and random effects models to calculate the odds ratio and mean difference in the ZP group and the CP group. Results Fourteen trials with a total of 1067 participants were identified. ZP group had a lower rate of postoperative dysphagia at the 2- or 3-month and 6-month follow-up than CP group, and ZP group was associated with a decreased ASD rate at the last follow-up when compared with the CP group. The pooled data of radiologic outcomes revealed that there was no significant difference in postoperative and last follow-up IDH. However, postoperative and last follow-up cervical Cobb angle was significantly smaller in the ZP group when compared with the CP group. In subgroup analyses, when the length of the last follow-up was less than 3 years, there was no difference between two groups. However, as the last follow-up time increased, cervical Cobb angle was significantly lower in the ZP group when compared with the CP group. Conclusion Based on the results of our analysis, the application of ZP device in ACDF had a lower rate of postoperative dysphagia and ASD than CP construct. Both devices were safe in anterior cervical surgeries, and they had similar efficacy in correcting radiologic outcomes. However, as the last follow-up time increased, ZP group showed greater changes cervical alignment. In order to clarify the specific significance of LOC, additional large clinical studies with longer follow-up period are required.

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Section: Discussionmentioning

confidence: 99%

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

et al. 2022

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“…*P < 0.05, compared with preoperative value; #P < 0.05 significant difference between the two groups. for two and three levels, whereas single-level fixation provided equal stiffness (19,22,23). This may be the reason why there were variations in radiological measurements between singlelevel and mixed-level with ZP and ST cages.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the ST and ZP groups both showed a substantial increase in the degree of cervical lordosis at the final follow-up, while both groups had substantial improvements in VAS, NDI, and JOA ratings in the postoperative period. In addition, a biomechanical study showed that cages with fixation provided greater structural strength than ST spacers for two and three levels, whereas single-level fixation provided equal stiffness ( 19 , 22 , 23 ). This may be the reason why there were variations in radiological measurements between single-level and mixed-level with ZP and ST cages.…”

Section: Discussionmentioning

confidence: 99%

Anterior cervical discectomy and fusion with zero-profile versus stand-alone cages for two-level cervical spondylosis: A retrospective cohort study

Chen²,

Fu³

et al. 2022

Front. Surg.

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ObjectiveTo assess the mid-long-term clinical and radiological outcomes of zero-profile (ZP) compared with stand-alone (ST) cages for two-level anterior cervical discectomy and fusion (ACDF).MethodsWe included 77 patients (39 women and 38 men) who underwent two-level ACDF between May 5, 2016, and May 5, 2020, and who were followed up for at least 1 year. The subjects were divided into the ST (n = 38) and ZP (n = 39) group. For the evaluation of functional status, Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores were used. Additionally, radiological outcomes and procedure complications were observed at final follow-up.ResultsBoth groups had excellent clinical outcomes at the final follow-up. There were no significant intergroup (ZP vs. ST) differences in the fusion rate (91.02% vs. 90.79%, P > 0.05) and postoperative dysphagia (15.4% vs. 2.6%, P = 0.108). However, the disc height at the final follow-up in the ZP group was higher than that in the ST group (6.86 ± 0.84 vs. 6.17 ± 1.03, P = 0.002). The ZP group accomplished a lower loss of cervical lordosis (18.46 ± 4.78 vs. 16.55 ± 4.36, P = 0.071), but without reaching statistical significance.ConclusionACDF with either ZP or ST cages turns out to be a dependable strategy for two-level ACDF in terms of clinical results. However, compared with the ST, the ZP cage may achieve a significantly lower loss of disc height.

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Long-term effectiveness of stand-alone anchored spacer in multilevel anterior cervical discectomy and fusion compared with cage-plate system: a systematic review and meta-analysis

Zhang,

Ju,

2024

Eur Spine J

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Biomechanical evaluation comparing zero-profile devices versus fixed profile systems in a cervical hybrid decompression model: a biomechanical in vitro study

Cited by 6 publications

References 35 publications

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

Anterior cervical discectomy and fusion with zero-profile versus stand-alone cages for two-level cervical spondylosis: A retrospective cohort study

Long-term effectiveness of stand-alone anchored spacer in multilevel anterior cervical discectomy and fusion compared with cage-plate system: a systematic review and meta-analysis

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