Anterior cervical discectomy and fusion with zero-profile versus stand-alone cages for two-level cervical spondylosis: A retrospective cohort study

ObjectiveTo assess the mid-long-term clinical and radiological outcomes of zero-profile (ZP) compared with stand-alone (ST) cages for two-level anterior cervical discectomy and fusion (ACDF). MethodsWe included 77 patients (39 women and 38 men) who underwent two-level ACDF between May 5, 2016, and May 5, 2020, and who were followed up for at least 1 year. The subjects were divided into the ST (n = 38) and ZP (n = 39) group. For the evaluation of functional status, Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores were used. Additionally, radiological outcomes and procedure complications were observed at final follow-up. ResultsBoth groups had excellent clinical outcomes at the final follow-up. There were no significant intergroup (ZP vs. ST) differences in the fusion rate (91.02% vs. 90.79%, P > 0.05) and postoperative dysphagia (15.4% vs. 2.6%, P = 0.108). However, the disc height at the final follow-up in the ZP group was higher than that in the ST group (6.86 +/- 0.84 vs. 6.17 +/- 1.03, P = 0.002). The ZP group accomplished a lower loss of cervical lordosis (18.46 +/- 4.78 vs. 16.55 +/- 4.36, P = 0.071), but without reaching statistical significance. ConclusionACDF with either ZP or ST cages turns out to be a dependable strategy for two-level ACDF in terms of clinical results. However, compared with the ST, the ZP cage may achieve a significantly lower loss of disc height.

Automated summary

This study compared the clinical and radiological outcomes of zero-profile (ZP) and stand-alone (ST) cages in two-level anterior cervical discectomy and fusion (ACDF). The results showed that both ZP and ST cages provided reliable clinical outcomes, but the ZP cage may be more effective in reducing disc height loss.