Objective:

To compare clinical and radiological outcomes of the Zero-P VA device with the plate-cage construct (PCC) in single-level anterior cervical discectomy and fusion (ACDF), highlighting the significance of this comparison.

Key Findings:

• Both groups showed significant improvement in VAS and JOA scores postoperatively, indicating effective pain management.
• The Zero-P VA group experienced a significant decrease in segmental angle and anterior height at 3 and 12 months compared to immediate postoperative values, raising concerns about long-term stability.
• The rate of segmental kyphosis was significantly higher in the Zero-P VA group at 12 months (12% vs. 0%, p < 0.05), suggesting potential complications.
• Fusion rates were comparable between the two groups, indicating similar effectiveness in achieving fusion.

Interpretation:

The Zero-P VA device offers comparable short-term clinical outcomes to the PCC but demonstrates inferior radiological outcomes, particularly in segmental lordosis and anterior surgical segment height, which may impact long-term patient outcomes.

Limitations:

• Retrospective design may introduce bias.
• Limited sample size may affect generalizability.
• Follow-up duration may not capture long-term outcomes.
• Potential biases in outcome measurement should be considered.

Conclusion:

The choice of implant involves a trade-off between the advantages of a zero-profile system and the superior radiological stability of the PCC, emphasizing the need for careful consideration in surgical planning.