The Use of Zero Profile Cage Plate for the Management of Cervical Disc Disease


The Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University


Abstract Background: Several studies reported fusion rates are higher with anterior cervical decompression and fusion (ACDF) procedure if supplemented with a plate. However, plates may be associated with postoperative morbidity and higher rates of dysphagia. Zero-p implant for stand-alone cage plate used in ACDF was developed to avoid complications associated with anterior cervical plates owing to the zero profile of the construct. Aim of Study: The aim of this study to evaluate the functional as well as radiological outcome of Zero-p cage plate for the management of cervical disc disease. Material and Methods: 30 patients (16 male and 14 female) were selected to undergo ACDF with Zero-p implant, the mean age was 47.93 (±10.9) years, a total of 43 operated levels (20 patients one level operated, 7 patients 2 levels operated, and 3 patients 3 levels operated, and the mean follow-up was 12.3 months. These patients underwent pre- and postoperative clinical and neurological evaluation and scoring systems using visual analogue scale VAS for neck and radicular pain, neck disability index NDI, and Bazaz-Yoo dysphagia index for postoperative dysphagia. Postoperative X-ray evaluation was done for evaluation of fusion and implant associated complications at 1,3,6,9, and 12 months. Results: All patients had significant reduction in arm and neck pain and NDI maintained over the follow-up period p value was (<0.0001) with reduction of VAS for neck pain from 7.33 preoperatively to 1.37 at 12 months follow-up and also VAS for radicular pain from 8.70 preoperatively to 0.27 at 12 months follow-up, and reduction of NDI from 68.87% preoperatively to 8.60% at 12 months follow-up. None had dysphagia after 6 months postoperatively, one patient devel-oped back-out of one of the implant screws that was extracted, and otherwise no other implant related complications. Conclusion: The Zero-p implant is a valid alternative to anterior cervical plating after ACDF with a very low incidence of chronic dysphagia, and implant-related complications.