Stand-alone (SA) zero-profile implants are an alternative to cervical plating (CP) in anterior cervical
discectomy and fusion (ACDF). In this study, we investigate differences in surgical outcomes between SA and CP in ACDF. We conducted a retrospective analysis of 166 patients with
myelopathy and/or
radiculopathy who had ACDF with SA or CP from Jan 2013-Dec 2016. We measured surgical outcomes including Bazaz
dysphagia score at 3 months, Nurick grade at last follow-up, and length of
hospital stay. 166 patients (92F/74M) were reviewed. 92 presented with
radiculopathy (55%), 37 with
myelopathy (22%), and 37 with myeloradiculopathy (22%). The average
operative time with CP was longer than SA (194 ± 69 vs. 126 ± 46 min) (p < 0.001), as was the average length of
hospital stay (2.1 ± 2 vs. 1.5 ± 1 days) (p = 0.006). At 3 months, 82 patients (49.4%) had a follow-up for
dysphagia, with 3 patients reporting mild
dysphagia and none reporting moderate or severe
dysphagia. Nurick grade at last follow-up for the
myelopathy and myeloradiculopathy cohorts improved in 63 patients (85%). Prolonged
length of stay was associated with reduced odds of having an optimal outcome by 0.50 (CI = 0.35-0.85, p = 0.003). Overall, we demonstrate that there is no significant difference in neurological outcome or rates of
dysphagia between SA and CP, and that both lead to overall improvement of symptoms based on Nurick grading. However, we also show that the SA group has shorter length of
hospital stay and
operative time compared to CP.