PT  - JOURNAL ARTICLE
AU  - Thind, Harjot
AU  - Aura, Angela Beliveau
AU  - Lee, Paul
AU  - Shen, Peter
AU  - Li, Chin-Shang
AU  - Klineberg, Eric O.
AU  - Kim, Kee D.
AU  - Panchal, Ripul R.
TI  - 2-Level Anterior Cervical Arthrodesis With Integrated Spacer and Plate vs Traditional Anterior Spacer and Plate System
AID  - 10.14444/8206
DP  - 2022 Apr 01
TA  - International Journal of Spine Surgery
PG  - 215--221
VI  - 16
IP  - 2
4099  - https://www.ijssurgery.com/content/16/2/215.short
4100  - https://www.ijssurgery.com/content/16/2/215.full
SO  - Int J Spine Surg2022 Apr 01; 16
AB  - Background Anterior cervical discectomy and fusion (ACDF) is a common surgery to treat cervical degenerative disc disease. Use of an anterior spacer and plate system (ASPS) results in increased disc height, higher fusion rate, lower subsidence rate, and lower complication rate than a spacer alone.1,2 However, anterior cervical plating is associated with complications, such as dysphagia, plate-screw dislodgment, soft tissue injury, neural injury, and esophageal perforation.3–9 To potentially reduce these drawbacks, integrated spacer and plate (ISP) systems have gained popularity.Methods From November 2009 to October 2013, a total of 84 consecutive patients who underwent 2-level ACDF using ISP or ASPS were reviewed for clinical and radiographic outcomes. Patient-reported visual analog scale (VAS) and Neck Disability Index (NDI) scores, fusion rates, and hardware failure were determined at 1, 3, 6, 12, and 24 months after surgery.Results Forty-three patients received ISP and 41 patients received ASPS. There were no significant differences in patient demographics between the 2 groups. Perioperative characteristics were similar, except for operative time. Postoperatively, no significant differences in VAS or NDI scores or fusion status were found. At the proximal surgical level only, there was a trend toward an earlier observed radiographic fusion rate in ASPS vs ISP, but this finding was not statistically significant (P = 0.092). One case of long-term dysphagia was reported in each group. Neither group had implant failures up to 2 years.Conclusions The ISP system for 2-level ACDF compared to traditional ASPS has comparable clinical and radiographic outcomes up to 2 years postoperatively. There may be a trend toward an earlier observed radiographic fusion in the ASPS group, but there was no difference in long-term dysphagia rate.Clinical Relavance Integrated spacer and traditional anterior spacer for 2-level ACDF has similar clinical and radiographical outcome.Level of Evidence 4.