title: Meta-Analysis Comparing Zero-Profile Spacer and Anterior Plate in Anterior Cervical Fusion.
abstract: BACKGROUND
  Anterior 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Ten 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.
  
  
  CONCLUSIONS
  Compared 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.
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Teng
authors.initials: T
authors.lastname: Lu
authors.affiliation: Department of Plastic Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Baobao
authors.initials: B
authors.lastname: Liang
authors.affiliation: Department of Orthopaedics, Xi'an Honghui hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710054, China.
authors.forename: Junkui
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710061, China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Lv
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Cai
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Sihua
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Haopeng
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
authors.forename: Xijing
authors.initials: X
authors.lastname: He
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000517:prevention & control; D017586:Diskectomy / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D013123:Spinal Fusion / Q000379:methods*; D055009:Spondylosis / Q000150:complications / Q000601:surgery*