ZERO-PROFILE ANCHORED SPACER VERSUS PEEK CAGE WITH ANTERIOR PLATING FOR SINGLE-LEVEL TRAUMATIC CERVICAL SPINE INJURY

Abstract

Background: Anterior cervical discectomy and fusion is used to decompress and stabilize selected traumatic subaxial cervical injuries. A conventional polyetheretherketone cage with an anterior plate provides rigid fixation, but the plate may contribute to postoperative dysphagia. Zero-profile anchored spacers avoid a separate anterior plate. Objective: To compare fusion, postoperative dysphagia, neurological status, hospital stay, and pain after single-level anterior cervical discectomy and fusion with a zero-profile anchored spacer or a PEEK cage with anterior plating. Methods: This single-centre quasi-experimental study enrolled 46 patients with traumatic single-level C3-C7 injury by consecutive sampling. Twenty-three patients received a zero-profile anchored spacer (Group A), and 23 received a PEEK cage with anterior plating (Group B). Neurological status was graded with the American Spinal Injury Association Impairment Scale, dysphagia with the Bazaz system, pain with a 0-10 visual analogue scale, and fusion by postoperative imaging. Between-group comparisons used independent-samples t tests, Pearson chi-square tests, or two-sided Fisher exact tests, as appropriate; effect estimates are reported with 95% confidence intervals. Results: Fusion occurred in 21/23 patients (91.30%) in Group A and 20/23 (86.96%) in Group B (two-sided Fisher exact p=1.000). Dysphagia occurred in 2/23 (8.70%) and 3/23 (13.04%), respectively (p=1.000). At discharge, ASIA grade distributions did not differ (Pearson chi-square p=0.348). Mean hospital stay was 25.18 +/- 6.04 days in Group A and 28.74 +/- 2.99 days in Group B, a reduction of 3.56 days (95% CI 0.73-6.39; p=0.015; Hedges g=0.73). VAS scores at six months were 2.00 +/- 0.00 and 2.13 +/- 0.34 (p=0.073). Conclusion: The zero-profile anchored spacer significantly reduced hospital stay while achieving a high fusion rate, a lower observed frequency of dysphagia, and favourable neurological and pain outcomes. These findings support the zero-profile construct as an effective alternative to plate-cage fixation, although the small nonrandomized sample limits claims of overall superiority.