A Clinical Comparison of Anterior Cervical Plates versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures.
World Neurosurg. 2016 Dec 22;:
Authors: Panchal RR, Kim KD, Eastlack R, Lopez J, Clavenna A, Brooks DM, Joshua G
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 (DDD) requiring ACDF at a single level at C3-C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers (SA), and 28 with plate fixation and spacers (PS). Analyses were based on comparison of perioperative outcomes, radiological 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±34.4min, 114.4±31.5min), estimated blood loss (44.8±76.5cc, 82.5±195.1cc), or length of hospital stay (1.2±0.6days, 1.3±0.6days). Mean visual analog scale (VAS) pain scores and Neck Disability Index (NDI) scores improved significantly from preoperative to last follow-up (10.8±2.6mo) in both groups (P<0.05). Mean Voice Handicap Index (VHI) and Eating Assessment Tool (EAT) scores improved significantly from discharge to last follow-up in both groups (P<0.05). From discharge to 6 months, the SA group consistently demonstrated greater improvement in VHI. 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.
PMID: 28017756 [PubMed – as supplied by publisher]