The effectivity of Zero-Profile in treating Single-Level Traumatic Cervical Disc Herniation: A 3- year follow-up Retrospective Cohort Study

Objective: This study aims to compare the mid-term efficacy and safety of anterior cervical discectomy and fusion (ACDF) using the Zero-Profile device versus a cage-and-plate construct in treating single-level traumatic cervical disc herniation. Background： While the Zero-Profile device demonstrates comparable functional and radiological outcomes to the cage-and-plate system in single- and multi-level ACDF for cervical degenerative disc diseases, and reduces complication rates, particularly dysphagia, its suitability for single-level symptomatic traumatic cervical disc herniation remains unclear. Methods: Between August 2020 and August 2023, 50 patients with symptomatic traumatic cervical disc herniation underwent ACDF using either the Zero-Profile device (Group ZP) or the cage-and-plate system (Group CP). Clinical outcomes, including Japanese Orthopedic Association (JOA) scores, Neck Disability Index (NDI) scores, Visual Analogue Scale (VAS) scores, Hospital Anxiety and Depression Scale (HADS) scores, radiological outcomes, and complications, were evaluated and compared. Results: All procedures were successfully completed. Both groups demonstrated significant postoperative improvements in JOA, NDI, VAS scores, and cervical lordosis, with no significant differences between groups at any follow-up interval. Fusion and cage subsidence rates were also comparable. Notably, dysphagia rates immediately postoperatively, at 1 week, and at 1 month were lower in Group ZP (14.8%, 11.1%, and 3.7%) compared to Group CP (21.7%, 17.4%, and 13.0%) (P =0.79, 0.82 and 0.49). All patients achieved solid fusion, and no cases of dysphagia were observed at the final follow-up. In terms of HADS scores, no significant differences were observed between the two groups. Conclusions: ACDF using the Zero-Profile device provides comparable surgical outcomes to the cage-and-plate system for single-level traumatic cervical disc herniation while potentially reducing early postoperative dysphagia rates. Thus, it represents an effective and reliable treatment option for this condition.