Use of a Zero-Profile Device for Contiguous 2-Level Anterior Cervical Diskectomy and Fusion: Comparison with Cage with Plate Construct.
BACKGROUND
A new zero-profile, standalone device (Zero P) was recently developed and has shown a lower incidence rate of complications and competitive clinical outcomes compared with anterior cervical cage with plate construct (CP) in single and multilevel anterior cervical diskectomy and fusion (ACDF). However, there is still concern whether Zero P is appropriate for multilevel ACDF. In addition, there have been few reports of contiguous 2-level ACDF used in conjunction with Zero P.


METHODS
We reviewed contiguous 2-level ACDF performed from December 2006 to February 2015. A total of 63 patients met inclusion criteria for the study (CP group = 32 cases; Zero P group = 31 cases). All preoperative and postoperative clinical and radiologic parameters were recorded. These parameters were compared between both groups.


RESULTS
The postoperative change of Cobb S over time in the Zero P group was significantly different from that in the CP group. The maintenance of Cobb S in the Zero P group was better than that in the CP group (P < 0.05). The maintenance of anterior intervertebral disk height (IDH) at postoperative assessment for the Zero P group was significantly better than that in the CP group (P < 0.05). Within-group comparison of the postoperative change of anterior and posterior IDH over time revealed that the anterior IDH was significantly lower than the posterior IDH in the Zero P group (P < 0.05).


CONCLUSIONS
For 2-level contiguous ACDF, the use of a zero-profile device has the capacity to show compatible outcomes in correction and maintenance of segmental angle if the anterior titanium alloy plate is properly positioned at the anterior vertebral line.
Department of Neurosurgery, Spine Health Wooridul Hospital, Busan, Korea. Electronic address: djyunns@gmail.com.
Dong-Ju
DJ
Yun
Department of Neurosurgery, Spine Health Wooridul Hospital, Busan, Korea.
Sang-Jin
SJ
Lee
Department of Neurosurgery, Spine Health Wooridul Hospital, Busan, Korea.
Sang-Joon
SJ
Park
Department of Neurosurgery, Spine Health Wooridul Hospital, Busan, Korea.
Hyeong Seok
HS
Oh
Department of Neurosurgery, Spine Health Wooridul Hospital, Busan, Korea.
Young Jae
YJ
Lee
Department of Neurosurgery, Spine Health Wooridul Hospital, Busan, Korea.
Hyun Min
HM
Oh
Department of Neurosurgery, Spine Health Wooridul Hospital, Gangnam, Seoul, Korea.
Sang-Ho
SH
Lee
D001860:Bone Plates / Q000706:statistics & numerical data*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D017586:Diskectomy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*
Anterior cervical diskectomy and fusion; Anterior cervical plate and cage; Cervical angle; Fibular allograft; Intervertebral disk height; Subsidence; Zero P