title: Zero-profile implant versus conventional cage-plate implant in anterior cervical discectomy and fusion for the treatment of degenerative cervical spondylosis: a meta-analysis.
abstract: BACKGROUND
  Zero-profile implant has become more and more popular in anterior cervical discectomy and fusion (ACDF) for the treatment of degenerative cervical spondylosis. However, there was no enough evidence judging its efficiency and safety. The aim of this analysis was to evaluate the efficacy and safety of Zero-profile implant compared with conventional cage-plate (CCP) in ACDF.
  
  
  METHODS
  All studies directly comparing the outcomes between the Zero-profile implant and CCP implant in ACDF were included, and the search strategy followed the requirements of the Cochrane Library Handbook. Two of the authors extracted relevant data and checked the accuracy independently using standardized data collection form.
  
  
  RESULTS
  Seven studies involving 560 patients were included, 262 in the Zero-profile group and 298 in the CCP group. Zero-profile implant had a lower rate of postoperative dysphagia at 2 weeks, 6 months, and 1 year (p = 0.0002, p = 0.008, and p = 0.001, respectively) than CCP implant. Zero-profile also reduced blood loss (p = 0.0001), while operation time and incidence of postoperative transient dysphagia had no statistical significance (p = 0.92, p = 0.42, respectively) between two groups.
  
  
  CONCLUSIONS
  Based on the results of our analysis, the application of Zero-profile implant in ACDF had a lower rate of postoperative dysphagia at 2 weeks, 6 months, and 1 year than CCP implant. Zero-profile implant also had fewer blood loss during operation. More rigorous and adequately powered prospective randomized controlled trials with larger sample size are required to elucidate a more objective outcome.
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, No.158, Shangtang Road, Hangzhou, 310000, Zhejiang, China. shaohaiyu@163.com.
authors.forename: Haiyu
authors.initials: H
authors.lastname: Shao
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, No.158, Shangtang Road, Hangzhou, 310000, Zhejiang, China. y1028263755@126.com.
authors.forename: Jinping
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, No.158, Shangtang Road, Hangzhou, 310000, Zhejiang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Ru
authors.affiliation: Department of Medicine, Zhejiang University, No.268, Kaixuan Road, Hangzhou, 310000, Zhejiang, China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Yan
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, No.158, Shangtang Road, Hangzhou, 310000, Zhejiang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, No.158, Shangtang Road, Hangzhou, 310000, Zhejiang, China.
authors.forename: Shaonan
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, Zhejiang Provincial People's Hospital, No.158, Shangtang Road, Hangzhou, 310000, Zhejiang, China.
authors.forename: Yazeng
authors.initials: Y
authors.lastname: Huang
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D055009:Spondylosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome