Clinical Scorecard: Assessment of the Zero-Profile Device Featuring Dual Integrated Variable Angle Screws for Single-Level Cervical Degenerative Disc Disease: A Comparative Study with the Plate-Cage System

At a Glance

Key Highlights

• Zero-P VA device provides comparable short-term clinical outcomes to plate-cage construct in single-level ACDF.
• Zero-P VA device is associated with greater loss of segmental lordosis and anterior surgical segment height over 12 months.
• Segmental kyphosis rate is significantly higher with the Zero-P VA device compared to the plate-cage construct.

Guideline-Based Recommendations

Diagnosis

• Diagnosis based on clinical presentation of cervical degenerative disc disease with radiculopathy or myelopathy refractory to conservative treatment.
• Radiological assessment using standard lateral cervical x-rays preoperatively and during follow-up.

Management

• Consider ACDF with either Zero-P VA device or plate-cage construct for single-level cervical degenerative disc disease.
• Surgeon should weigh the trade-off between reduced complications with zero-profile devices and superior radiological stability with plate-cage constructs.

Monitoring & Follow-up

• Postoperative clinical evaluation using Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores.
• Radiological follow-up at immediate postoperative, 3 months, and 12 months to assess cervical alignment, segmental angle, and surgical segment height.

Risks

• Zero-P VA device may lead to increased segmental kyphosis and loss of anterior surgical segment height.
• Plate-cage constructs carry risks of complications such as dysphagia, adjacent segment degeneration, and esophageal injury due to anterior plating.

Patient & Prescribing Data

Patients undergoing single-level ACDF for cervical degenerative disc disease

Zero-P VA device offers clinical outcomes comparable to plate-cage constructs but with inferior radiological stability; choice depends on balancing surgical advantages and long-term stability.

Clinical Best Practices

• Use zero-profile devices to reduce surgical exposure and minimize complications like postoperative dysphagia.
• Employ plate-cage constructs when superior radiological stability and maintenance of lordosis are prioritized.
• Perform regular postoperative clinical and radiological assessments to monitor fusion and alignment.
• Consider individual patient anatomy and risk factors when selecting implant type for ACDF.

References

• Frontiers in Surgery, 2026, Volume 13