The use of a zero-profile device compared with an anterior plate and cage in the treatment of patients with symptomatic cervical spondylosis

Abstract

In a retrospective cohort study we compared the clinical outcome and complications, including dysphagia, following anterior cervical fusion for the treatment of cervical spondylosis using either a zero-profile (Zero-P; Synthes) implant or an anterior cervical plate and cage. A total of 83 patients underwent fusion using a Zero-P and 107 patients underwent fusion using a plate and cage. The mean follow-up was 18.6 months (SD 4.2) in the Zero-P group and 19.3 months (SD 4.1) in the plate and cage group. All patients in both groups had significant symptomatic and neurological improvement. There were no significant differences between the groups in the Neck Disability Index (NDI) and visual analogue scores at final follow-up. The cervical alignment improved in both groups. There was a higher incidence of dysphagia in the plate and cage group on the day after surgery and at two months post-operatively. All patients achieved fusion and no graft migration or nonunion was observed. When compared with the traditional anterior cervical plate and cage, the Zero-P implant is a safe and convenient procedure giving good results in patients with symptomatic cervical spondylosis with a reduced incidence of dysphagia post-operatively.

Comparison among perfect-C®, zero-P®, and plates with a cage in single-level cervical degenerative disc disease

“…Herein, we explain various aspects of the Perfect-C in comparison with the Zero-P and the plate-with-cage system. The Zero-P device is relatively easy to use, and the mean length of the operation and amount of blood loss were previously shown to be lower than for Plate-Cage surgeries in one-and two-level procedures [17]. A significant decrease in intraoperative blood loss was confirmed for one-level surgery, and a significant decrease in the length of the operation was demonstrated for two-level surgery in patients treated using the Zero-P device [18].…”

“…The Perfect-C implant is a new integrated cage and plate device that combines the benefits of an anterior plate and a cage to help avoid complications such as HO and dysphasia. The Zero-P leads to good fusion rate and biomechanical stability and both the Zero-P and Perfect-C implants can be used to correct cervical kyphosis and improve cervical alignment [17]. Herein, we explain various aspects of the Perfect-C in comparison with the Zero-P and the plate-with-cage system.…”

Outcome evaluation of zero-profile implant compared with an anterior plate and cage used in anterior cervical discectomy and fusion: a two-year follow-up study

“…The Zero-P device can be inserted into the disc space directly and the screws can be easily installed with the help of the trajectories. Thus smaller operative field and fewer steps are needed to place the Zero-P with only a little part of the upper and lower vertebrae of the responsible segment exposed, and the one-step locking mechanism with simple insertion of the cage and tightening of the screws (16). The less esophagus retraction extent and less intraoperative retraction time to install the Zero-P device may also contribute to the lower rate of dysphagia (17).…”

Does a Zero-Profile Anchored Cage Offer Additional Stabilization as Anterior Cervical Plate?

“…2 , 3 Because these shortcomings of the SC and anterior cervical plate (ACP) are being improved upon, the use of ACs is gradually increasing. [1][2][3][4][5] Most authors have indicated that radiological and clinical outcomes of ACs are similar to those of cages with plates (CPs) and have particularly emphasized the point about the decreased occurrence of postoperative dysphasia. [1][2][3][4][5][6] ACs maintained comparable stability with CPs in one biomechanical study, but ACs showed a higher range of motion in fl exion/extension 7 ; in contrast, other articles reported that ACs lack multilevel stability.…”

“…[1][2][3][4][5] Most authors have indicated that radiological and clinical outcomes of ACs are similar to those of cages with plates (CPs) and have particularly emphasized the point about the decreased occurrence of postoperative dysphasia. [1][2][3][4][5][6] ACs maintained comparable stability with CPs in one biomechanical study, but ACs showed a higher range of motion in fl exion/extension 7 ; in contrast, other articles reported that ACs lack multilevel stability. 8 In our study, using SCs in patients with single-level cervical disc disease for comparison, the degree of additional stability provided by the fi xation devices of an AC was determined on the basis of comparisons and analyses of the postoperative retention of cervical alignment and motion stabilization.…”