Zero-Profile Versus Cage and Plate in Anterior Cervical Discectomy and Fusion for the Treatment of single- level Traumatic Cervical Disc Herniation: A Minimum of Three-Year Follow-Up Study

Abstract Background Compared with cage and plate, Zero-Profile device in single and multi-level anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc diseases shows similar efficacy in improving functional and radiologic outcomes, and reducing incidence of complication rate, especially dysphasia. Whether Zero-Profile device is appropriate for ACDF in the treatment of single-level symptomatic traumatic cervical disc herniation is still unknow. We compare the mid-term efficacy and safety in ACDF using Zero-Profile device with cage and plate for the treatment of single-level traumatic cervical disc herniation. Methods From Aug 2014 to Aug 2018, 53 patients with symptomatic traumatic cervical disc herniation underwent ACDF with Zero-Profile device (Group ZP) or cage and plate (Group CP) were included. The clinical outcomes (Japanese Orthopedic Association score (JOA), Neck Disability Index (NDI) score, Visual Analogue Scale (VAS) score, radiological outcome and complications were reviewed and compared. Results All procedures were successfully performed in all patients. The JOA score, NDI score, VAS score and cervical lordosis were significantly improved postoperatively in both groups (P < 0.05), but there were no significant differences between the two groups at each follow-up time (P > 0.05). There were no significant differences in fusion rate and cage subsidence rate between the two groups (P > 0.05). However, the dysphagia rate at postoperative immediately, 1 week and 1 month in Group ZP (14.8%, 11.10% and 3.7%) were lower than those of Group CP (21.7%, 17.4% and 13.0%) (P > 0.05). All patients achieved solid fusion and no patient had dysphagia at final follow-up. Conclusions ACDF with Zero-Profile device can not only obtain similar surgical effects compared with cage and plate in the treatment of single-level traumatic cervical disc herniation, but may reduce the incidence of dysphagia rate at early post operative period. Therefore, ACDF with Zero-Profile can be used as an effective and reliable treatment for single-level traumatic cervical disc herniation.