RT Journal Article
SR Electronic
T1 2-Level Anterior Cervical Arthrodesis With Integrated Spacer and Plate vs Traditional Anterior Spacer and Plate System
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 215
OP 221
DO 10.14444/8206
VO 16
IS 2
A1 Thind, Harjot
A1 Aura, Angela Beliveau
A1 Lee, Paul
A1 Shen, Peter
A1 Li, Chin-Shang
A1 Klineberg, Eric O.
A1 Kim, Kee D.
A1 Panchal, Ripul R.
YR 2022
UL https://www.ijssurgery.com/content/16/2/215.abstract
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.