Outcome Evaluation of the Zero-Profile Device Comprising Two Integrated Variable Angle Screws Used for Single-Level Cervical Degenerative Disc Disease: Comparison with the Plate-Cage Construct - Report - MDSpire
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Outcome Evaluation of the Zero-Profile Device Comprising Two Integrated Variable Angle Screws Used for Single-Level Cervical Degenerative Disc Disease: Comparison with the Plate-Cage Construct
Clinical Report: Zero-Profile Device vs Plate-Cage in Single-Level Cervical ACDF
Overview
This study compared clinical and radiological outcomes of the Zero-P VA device with the traditional plate-cage construct (PCC) in single-level anterior cervical discectomy and fusion (ACDF). Both devices yielded comparable short-term clinical improvements, but the Zero-P VA showed inferior radiological stability, including greater loss of segmental lordosis and anterior surgical segment height.
Background
Cervical degenerative disc disease often requires surgical intervention such as ACDF when conservative treatments fail. Traditional ACDF uses a plate-cage construct to provide immediate stabilization and restore cervical lordosis but may cause complications like dysphagia. Zero-profile devices, including the Zero-P VA with two integrated variable-angle screws, aim to reduce such complications by minimizing anterior profile and esophageal irritation. However, concerns remain regarding their mechanical stability and radiological outcomes compared to PCC.
Data Highlights
Outcome
Zero-P VA Group
PCC Group
Significance
Number of cases
50
51
–
VAS and JOA scores
Significant improvement postoperatively
Significant improvement postoperatively
Comparable
Segmental angle and anterior height at 3 and 12 months
Significant decrease vs immediate postoperative; lower than PCC
Maintained better values
p < 0.05
Segmental kyphosis rate at 12 months
12%
0%
p < 0.05
Fusion rates
Comparable
Comparable
Not significant
Key Findings
Both Zero-P VA and PCC groups showed significant postoperative improvement in pain (VAS) and neurological function (JOA scores).
Zero-P VA group experienced significant loss of segmental lordosis and anterior surgical segment height at 3 and 12 months postoperatively compared to immediate postoperative values and PCC group.
The rate of segmental kyphosis at 12 months was significantly higher in the Zero-P VA group (12%) versus none in the PCC group.
Fusion rates were similar between the two groups, indicating comparable biological fusion success.
The Zero-P VA device offers a zero-profile design potentially reducing complications related to anterior plating but at the cost of inferior radiological stability.
Clinical Implications
Surgeons should weigh the benefits of reduced soft tissue irritation and potential complications with zero-profile devices like the Zero-P VA against their inferior radiological stability compared to PCC. While clinical outcomes are similar in the short term, the increased risk of segmental kyphosis and loss of lordosis with Zero-P VA may impact long-term spinal alignment and function. Implant choice should be individualized based on patient anatomy and risk factors.
Conclusion
The Zero-P VA device provides comparable short-term clinical outcomes to the plate-cage construct in single-level ACDF but demonstrates inferior radiological stability, particularly in maintaining segmental lordosis and height. This trade-off should guide implant selection in clinical practice.
