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Paper title Comparison of Clinical Outcomes Between Stand-Alone Zero-Profile and Cervical Plate for Single and Multilevel Anterior Cervical Discectomy and Fusion: A Prospective Analysis
Paper code P31
  1. Samuel Sommaruga Geneva University Hospitals (HUG) Speaker
  2. Joaquin Camara-Quitana Yale University
  3. Michael Robinson University of Cincinnati College of Medicine
  4. Aria Nouri University of Cincinnati College of Medicine
  5. Justin Virojanapa Yale University
  6. Xin Sun Yale University
  7. Luis Kolb Yale University
  8. Kishan Patel Yale University
  9. Enrico Tessitore Hôpitaux Universitaires Genève
  10. Patrick Tomak Yale University
  11. Khalid Abbed Yale University
  12. Karl Schaller HUG Hôpitaux Universitaires Genève
  13. Joseph Cheng University of Cincinnati College of Medicine
Form of presentation Poster
  • SSNS-Neurosurgery
Abstract text Aims: The stand-alone (SA) zero-profile implant has become an attractive alternative to cervical plating (CP) in anterior cervical discectomy and fusion (ACDF) for the treatment of degenerative cervical myelopathy (DCM) and radiculopathy (DCR). We undertook an ambispective study to investigate differences between DCM and DCR patients receiving SA or CP.

We conducted a retrospective analysis of a prospective cohort of consecutive patients with DCM and DCR who underwent ACDF with SA or CP from 2013 to 2016. Outcome measurements included: Bazaz dysphagia score at 3 months, post-operative steroid use, and Nurick grade at last follow-up. Neurological outcome was dichotomized with the Nurick grade. Assessments of differences between outcomes were performed using the Fisher exact test for categorical variables and the Mann-Whitney U test for continuous variables. A multivariate logistic regression model was constructed using variables that reached the predetermined significance level in the univariate analysis.

Of the 166 patients (92 females) ranging in age from 23 to 85 years (mean = 53 years), 84 (51%) presented with radiculopathy, 36 (21%) with myelopathy, 35 (21%) with myeloradiculopathy and 11 (7%) with intractable pain. From this group, 85 patients (51%) received surgical treatment at 1 level, 65 patients (39%) at 2 levels, and 16 patients (10%) at 3 levels. The average time of surgery was 150 (64) minutes, with a statistically significant (p-value = 2.5x10-9) longer average time of 195 (70) minutes for CP vs. 127 (46) minutes for SA. The SA group had a statistically significant (p-value = 0.024) shorter length of stay (1.51 day) than the CP group (2.12 days), and the length of stay of the total population was (1.71 days). Nurick grade improved in 140 patients while 26 patients showed no change or worse Nurick grade. Multivariate analysis revealed no statistically significant independent predictors of outcome between SA or CP.

This study is one of the largest studies comparing SA and CP. Our analysis demonstrated that there were no statistically significant differences in rates of and neurological outcome between CP and SA. However, it has been shown here that length of hospital stay and the operative time was shorter in patients with SA