title: A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures.
abstract: OBJECTIVE
  To compare radiologic and clinical outcomes, including rates of dysphagia and dysphonia, using a no-profile stand-alone intervertebral spacer with integrated screw fixation versus an anterior cervical plate and spacer construct for single-level anterior cervical discectomy and fusion (ACDF) procedures.
  
  
  METHODS
  This multicenter, randomized, prospective study included 54 patients with degenerative disc disease requiring ACDF at a single level at C3-C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers, and 28 with plate fixation and spacers. Analyses were based on comparison of perioperative outcomes, radiologic and clinical metrics, and incidence of dysphagia and/or dysphonia.
  
  
  RESULTS
  Mean patient age was 48.8 ± 10.1years (53.7% female). No significant differences were observed between groups in operative time (101.8 ± 34.4 minutes, 114.4 ± 31.5 minutes), estimated blood loss (44.8 ± 76.5 mL, 82.5 ± 195.1 mL), or length of hospital stay (1.2 ± 0.6 days, 1.3 ± 0.6 days). Mean visual analog scale pain scores and Neck Disability Index scores improved significantly from preoperative to last follow-up (10.8 ± 2.6 months) in both groups (P < 0.05). Mean Voice Handicap Index and Eating Assessment Tool scores improved significantly from discharge to last follow-up in both groups (P < 0.05). From discharge to 6 months, the stand-alone spacers group consistently demonstrated greater improvement in Voice Handicap Index. Preoperative intervertebral disc and neuroforaminal heights increased significantly across treatment groups (P < 0.01), and no cases required surgical revision at index or adjacent levels.
  
  
  CONCLUSIONS
  Anterior cervical discectomy and fusion with stand-alone spacers resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia.
authors.affiliation: Department of Neurological Surgery, University of California, Davis Medical Center, Sacramento, California, USA. Electronic address: rrpanchal@ucdavis.edu.
authors.forename: Ripul R
authors.initials: RR
authors.lastname: Panchal
authors.affiliation: Department of Neurological Surgery, University of California, Davis Medical Center, Sacramento, California, USA.
authors.forename: Kee D
authors.initials: KD
authors.lastname: Kim
authors.affiliation: Scripps Clinic Torrey Pines, La Jolla, California, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Eastlack
authors.affiliation: Spine Care Specialists of Alaska, Fairbanks, Arkansas, USA.
authors.forename: John
authors.initials: J
authors.lastname: Lopez
authors.affiliation: North Central Surgery Center, Dallas, Texas, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Clavenna
authors.affiliation: Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical, Inc., Audubon, Pennsylvania, USA.
authors.forename: Daina M
authors.initials: DM
authors.lastname: Brooks
authors.affiliation: Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical, Inc., Audubon, Pennsylvania, USA.
authors.forename: Gita
authors.initials: G
authors.lastname: Joshua
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000453:epidemiology*; D017586:Diskectomy / Q000295:instrumentation* / Q000379:methods; D055154:Dysphonia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
keywords: Anterior cervical discectomy and fusion; Dysphagia; Dysphonia; Stand-alone intervertebral spacer with integrated screw fixation