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ACDF Using a Zero Profile Cage Plate for The Management Of Degenerative Cervical Disc Disease, Early Experience From A Middle Eastern Tertiary Hospital.


 Background: Management of cervical disc degenerative diseases through anterior cervical decompression and fusion (ACDF) using various implants had been reported, a Zero-p device used as a stand-alone cage plate in ACDF was introduced to offer higher safety and efficacy. In the current prospective cohort study, we aimed at reporting our early experience from a Middle Eastern tertiary hospital after using the Zero profile cage plate in the management of degenerative cervical disc diseases through ACDF by reporting the clinical, radiological outcomes as well as the incidence of complications. Methods: Thirty patients (16 male and 14 female) with a mean age of 47.9 ±10.9 underwent ACDF with Zero-p implant, a total of 43 operated levels (one level in 20 patients, double levels in 7, and multi-levels in 3). Clinical outcomes were evaluated according to VAS to measure the neck and radicular arm pain and neck disability index (NDI). Radiographic bony fusion was assessed according to Pitzen criteria, any perioperative complications were reported, and the presence of dysphagia was assessed according to the Bazaz-Yoo dysphagia index. Results: At a mean follow up of 14.4 ± 2.3 months, all patients obtained radiographic bony fusion, all patients had a significant reduction of neck and radicular arm pain with a mean VAS score of 7.33 and 8.70 preoperatively to 1.73 and 0.27 at 12 months follow-up respectively (p<0.0001), and reduction of NDI from 68.87% preoperatively to 8.60% at 12 months follow-up (p<0.0001). None had dysphagia after six months postoperatively; one patient developed back-out of one of the implant screws that was extracted, and otherwise, no other implant-related complications. Conclusion: the Zero-p implant is a valid alternative to anterior cervical plating after ACDF with a very low incidence of chronic dysphagia and implant-related complications.Level of Evidence Ⅳ