A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures

Ripul R. Panchal, Kee D Kim, Robert Eastlack, John Lopez, Andrew Clavenna, Daina M. Brooks, Gita Joshua

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective To compare radiologic and clinical outcomes, including rates of dysphagia and dysphonia, using a no-profile stand-alone intervertebral spacer with integrated screw fixation versus an anterior cervical plate and spacer construct for single-level anterior cervical discectomy and fusion (ACDF) procedures. Methods This multicenter, randomized, prospective study included 54 patients with degenerative disc disease requiring ACDF at a single level at C3–C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers, and 28 with plate fixation and spacers. Analyses were based on comparison of perioperative outcomes, radiologic and clinical metrics, and incidence of dysphagia and/or dysphonia. Results Mean patient age was 48.8 ± 10.1years (53.7% female). No significant differences were observed between groups in operative time (101.8 ± 34.4 minutes, 114.4 ± 31.5 minutes), estimated blood loss (44.8 ± 76.5 mL, 82.5 ± 195.1 mL), or length of hospital stay (1.2 ± 0.6 days, 1.3 ± 0.6 days). Mean visual analog scale pain scores and Neck Disability Index scores improved significantly from preoperative to last follow-up (10.8 ± 2.6 months) in both groups (P < 0.05). Mean Voice Handicap Index and Eating Assessment Tool scores improved significantly from discharge to last follow-up in both groups (P < 0.05). From discharge to 6 months, the stand-alone spacers group consistently demonstrated greater improvement in Voice Handicap Index. Preoperative intervertebral disc and neuroforaminal heights increased significantly across treatment groups (P < 0.01), and no cases required surgical revision at index or adjacent levels. Conclusions Anterior cervical discectomy and fusion with stand-alone spacers resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia.

Original languageEnglish (US)
Pages (from-to)630-637
Number of pages8
JournalWorld Neurosurgery
Volume99
DOIs
StatePublished - Mar 1 2017

Fingerprint

Diskectomy
Dysphonia
Equipment and Supplies
Deglutition Disorders
Length of Stay
Pain Measurement
Operative Time
Reoperation
Neck
Eating
Prospective Studies
Incidence
Therapeutics

Keywords

  • Anterior cervical discectomy and fusion
  • Dysphagia
  • Dysphonia
  • Stand-alone intervertebral spacer with integrated screw fixation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures. / Panchal, Ripul R.; Kim, Kee D; Eastlack, Robert; Lopez, John; Clavenna, Andrew; Brooks, Daina M.; Joshua, Gita.

In: World Neurosurgery, Vol. 99, 01.03.2017, p. 630-637.

Research output: Contribution to journalArticle

Panchal, Ripul R. ; Kim, Kee D ; Eastlack, Robert ; Lopez, John ; Clavenna, Andrew ; Brooks, Daina M. ; Joshua, Gita. / A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures. In: World Neurosurgery. 2017 ; Vol. 99. pp. 630-637.
@article{df328f797a4346eeab546d12f2a2c977,
title = "A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures",
abstract = "Objective To compare radiologic and clinical outcomes, including rates of dysphagia and dysphonia, using a no-profile stand-alone intervertebral spacer with integrated screw fixation versus an anterior cervical plate and spacer construct for single-level anterior cervical discectomy and fusion (ACDF) procedures. Methods This multicenter, randomized, prospective study included 54 patients with degenerative disc disease requiring ACDF at a single level at C3–C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers, and 28 with plate fixation and spacers. Analyses were based on comparison of perioperative outcomes, radiologic and clinical metrics, and incidence of dysphagia and/or dysphonia. Results Mean patient age was 48.8 ± 10.1years (53.7{\%} female). No significant differences were observed between groups in operative time (101.8 ± 34.4 minutes, 114.4 ± 31.5 minutes), estimated blood loss (44.8 ± 76.5 mL, 82.5 ± 195.1 mL), or length of hospital stay (1.2 ± 0.6 days, 1.3 ± 0.6 days). Mean visual analog scale pain scores and Neck Disability Index scores improved significantly from preoperative to last follow-up (10.8 ± 2.6 months) in both groups (P < 0.05). Mean Voice Handicap Index and Eating Assessment Tool scores improved significantly from discharge to last follow-up in both groups (P < 0.05). From discharge to 6 months, the stand-alone spacers group consistently demonstrated greater improvement in Voice Handicap Index. Preoperative intervertebral disc and neuroforaminal heights increased significantly across treatment groups (P < 0.01), and no cases required surgical revision at index or adjacent levels. Conclusions Anterior cervical discectomy and fusion with stand-alone spacers resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia.",
keywords = "Anterior cervical discectomy and fusion, Dysphagia, Dysphonia, Stand-alone intervertebral spacer with integrated screw fixation",
author = "Panchal, {Ripul R.} and Kim, {Kee D} and Robert Eastlack and John Lopez and Andrew Clavenna and Brooks, {Daina M.} and Gita Joshua",
year = "2017",
month = "3",
day = "1",
doi = "10.1016/j.wneu.2016.12.060",
language = "English (US)",
volume = "99",
pages = "630--637",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures

AU - Panchal, Ripul R.

AU - Kim, Kee D

AU - Eastlack, Robert

AU - Lopez, John

AU - Clavenna, Andrew

AU - Brooks, Daina M.

AU - Joshua, Gita

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objective To compare radiologic and clinical outcomes, including rates of dysphagia and dysphonia, using a no-profile stand-alone intervertebral spacer with integrated screw fixation versus an anterior cervical plate and spacer construct for single-level anterior cervical discectomy and fusion (ACDF) procedures. Methods This multicenter, randomized, prospective study included 54 patients with degenerative disc disease requiring ACDF at a single level at C3–C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers, and 28 with plate fixation and spacers. Analyses were based on comparison of perioperative outcomes, radiologic and clinical metrics, and incidence of dysphagia and/or dysphonia. Results Mean patient age was 48.8 ± 10.1years (53.7% female). No significant differences were observed between groups in operative time (101.8 ± 34.4 minutes, 114.4 ± 31.5 minutes), estimated blood loss (44.8 ± 76.5 mL, 82.5 ± 195.1 mL), or length of hospital stay (1.2 ± 0.6 days, 1.3 ± 0.6 days). Mean visual analog scale pain scores and Neck Disability Index scores improved significantly from preoperative to last follow-up (10.8 ± 2.6 months) in both groups (P < 0.05). Mean Voice Handicap Index and Eating Assessment Tool scores improved significantly from discharge to last follow-up in both groups (P < 0.05). From discharge to 6 months, the stand-alone spacers group consistently demonstrated greater improvement in Voice Handicap Index. Preoperative intervertebral disc and neuroforaminal heights increased significantly across treatment groups (P < 0.01), and no cases required surgical revision at index or adjacent levels. Conclusions Anterior cervical discectomy and fusion with stand-alone spacers resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia.

AB - Objective To compare radiologic and clinical outcomes, including rates of dysphagia and dysphonia, using a no-profile stand-alone intervertebral spacer with integrated screw fixation versus an anterior cervical plate and spacer construct for single-level anterior cervical discectomy and fusion (ACDF) procedures. Methods This multicenter, randomized, prospective study included 54 patients with degenerative disc disease requiring ACDF at a single level at C3–C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers, and 28 with plate fixation and spacers. Analyses were based on comparison of perioperative outcomes, radiologic and clinical metrics, and incidence of dysphagia and/or dysphonia. Results Mean patient age was 48.8 ± 10.1years (53.7% female). No significant differences were observed between groups in operative time (101.8 ± 34.4 minutes, 114.4 ± 31.5 minutes), estimated blood loss (44.8 ± 76.5 mL, 82.5 ± 195.1 mL), or length of hospital stay (1.2 ± 0.6 days, 1.3 ± 0.6 days). Mean visual analog scale pain scores and Neck Disability Index scores improved significantly from preoperative to last follow-up (10.8 ± 2.6 months) in both groups (P < 0.05). Mean Voice Handicap Index and Eating Assessment Tool scores improved significantly from discharge to last follow-up in both groups (P < 0.05). From discharge to 6 months, the stand-alone spacers group consistently demonstrated greater improvement in Voice Handicap Index. Preoperative intervertebral disc and neuroforaminal heights increased significantly across treatment groups (P < 0.01), and no cases required surgical revision at index or adjacent levels. Conclusions Anterior cervical discectomy and fusion with stand-alone spacers resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia.

KW - Anterior cervical discectomy and fusion

KW - Dysphagia

KW - Dysphonia

KW - Stand-alone intervertebral spacer with integrated screw fixation

UR - http://www.scopus.com/inward/record.url?scp=85010416806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85010416806&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2016.12.060

DO - 10.1016/j.wneu.2016.12.060

M3 - Article

VL - 99

SP - 630

EP - 637

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -