Abstract
Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three- and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three- and four-level ACDF.Methods: Two cohorts of patients who underwent ACDF for the treatment of three- and four-level disease were compared. Thirty-three patients underwent implantation of zero-profile devices that included titanium screw fixation (Group A). Thirty-five patients underwent implantation of stand-alone PEEK cages without any form of screw fixation (Group B).Results: In Group A, twenty-seven patients underwent a three-level and six patients a four-level ACDF, with a total of 105 levels. In Group B, thirty patients underwent a three-level and five patients underwent a four-level ACDF, with a total number of 110 levels. In Group A, the mean preoperative visual analog scale score (VAS) for arm pain was 6.4 (range 3-8), and the mean postoperative VAS for arm pain decreased to 2.5 (range 1-7). In group B, the mean preoperative VAS of arm pain was 7.1 (range 3-10), and the mean postoperative VAS of arm pain decreased to 2 (range 0-4). In Group A, four patients (12%) developed dysphagia, and in Group B, three patients (9%) developed dysphagia. Conclusions: This study found zero-profile instrumentation and PEEK cages to be both safe and effective for patients who underwent three- and four-level ACDF, comparable to reported series using plate devices. Rates of dysphagia for the cohort were much lower than reports using plate devices. Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery.
Highlights
How to cite this article Gerszten P C, Paschel E, Mashaly H, et al (September 10, 2016) Outcomes Evaluation of Zero-Profile Devices Compared to Stand-Alone PEEK Cages for the Treatment of Three- and Four-Level Cervical Disc Disease
Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery
Among the various approaches tailored for surgical management of cervical disc disease including anterior, posterior, or sometimes combined approaches, anterior cervical discectomy and fusion (ACDF) still remains the gold standard surgical approach for cervical spondylotic myelopathy with or without radiculopathy [1,2]
Summary
How to cite this article Gerszten P C, Paschel E, Mashaly H, et al (September 10, 2016) Outcomes Evaluation of Zero-Profile Devices Compared to Stand-Alone PEEK Cages for the Treatment of Three- and Four-Level Cervical Disc Disease. Multiple level cervical disc disease, especially three- and four-levels, may present a significant challenge to the spine surgeon [1]. Among the various approaches tailored for surgical management of cervical disc disease including anterior, posterior, or sometimes combined approaches, anterior cervical discectomy and fusion (ACDF) still remains the gold standard surgical approach for cervical spondylotic myelopathy with or without radiculopathy [1,2]. Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease.
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