• Xu Tao, Abhijith V Matur, Seth Street, Geet Shukla, Julia Garcia-Vargas, Jay Mehta, Kelly Childress, Henry O Duah, Justin Gibson, Daryn Cass, Andrew Wu, Benjamin Motley, Joseph Cheng, and Owoicho Adogwa.
• Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH.
• Spine. 2024 Jul 15; 49 (14): 973978973-978.

Study DesignRetrospective cohort.ObjectiveTo compare rates of all-cause surgical and medical complications between zero-profile (ZP; stand-alone) implants versus any graft type with an anterior plate in patients undergoing 1-2 level anterior cervical discectomy and fusion (ACDF) for treatment of degenerative cervical myeloradiculopathy.Summary Of Background DataDegenerative cervical myeloradiculopathy is increasingly prevalent in older adults. ACDF is a common surgical procedure for decompression of neural structures and stabilization and has been shown to have excellent outcomes. Although ACDFs performed with graft and plate have been the gold standard, more recently, ZP implants were developed to decrease implant-related complications, such as severe postoperative dysphagia. However, there is a paucity of papers comparing the surgical and medical complications profile of ZP (stand-alone) implants to grafts with plating systems.Materials And MethodsData were extracted from the PearlDiver Mariner Database using Current Procedural Terminology codes to classify patients into 1 level, 2 levels, and a total of 1-2 level ACDFs. Patients undergoing surgery for non-degenerative pathologies such as tumors, trauma, or infection were excluded.Results1:1 exact matching created 2 equal groups of 7284 patients who underwent 1-2 level ACDF with either grafting with a plate or ZP (stand-alone) implant. There were no statistically significant differences in all-cause surgical complications, pseudarthrosis rate, dysphagia, or need for revision surgery between both cohorts (risk ratio: 0.99, 95% CI: 0.80-1.21, P = 0.95). In addition, all-cause medical complications were similar between both cohorts (risk ratio: 1.07, 95% CI: 0.862-1.330, P = 0.573) or any specific surgical or medical complication included in this study.ConclusionAfter 1:1 exact matching, the results of this study suggest that ZP (stand-alone) implants have similar outcomes compared with grafts with plating systems, with no observed differences in all-cause surgical or medical complications profile.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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