2-Level Anterior Cervical Arthrodesis With Integrated Spacer and Plate vs Traditional Anterior Spacer and Plate System

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Figure
Lateral radiographs of the cervical spine implanted with (A) integrated spacer and plate and (B) traditional anterior spacer and plate system.

Table 1

Baseline characteristics of patients by study group.

Characteristic	Integrated Spacer and Plate, n (%)	Anterior Spacer and Plate System, n (%)	P
n	43	41
Age in years, mean ± SD	54.8 ± 8.8	58.1 ± 11.5	0.337
Sex			0.521
Male	21 (48.8)	23 (56.1)
Female	22 (51.2)	18 (43.9)
Clinical scores, mean ± SD
Visual analog scale	5.6 ± 2.5	6.3 ± 2.3	0.144
Neck Disability Index	26.9 ± 8.6	27.7 ± 9.1	0.733
Clinical presentation frequency
Neck pain	42 (97.7)	39 (95.1)	0.611
Suboccipital headaches	16 (37.2)	8 (19.5)	0.098
Diagnosis			0.100
Myelopathy	3 (7.0)	7 (17.1)
Radiculopathy	22 (51.2)	25 (61.0)
Myeloradiculopathy	18 (41.9)	9 (22.0)
Clinical comorbidity frequency
Smoker	18 (41.9)	12 (29.3)	0.261
Diabetes	7 (16.3)	14 (34.2)	0.079
Chronic oral steroid use	10 (23.3)	6 (14.6)	0.408
Osteoporosis/osteopenia	4 (9.3)	8 (19.5)	0.222
Rheumatologic disorder	9 (20.9)	9 (22.0)	1.000

Table 2

Intraoperative summary by study group.

Surgery Details	Integrated Spacer and Plate, n (%)	Anterior Spacer and Plate System, n (%)	P
Surgical levels			0.316
C3-C5	5 (11.6)	4 (9.8)
C4-C6	14 (32.6)	8 (19.5)
C5-C7	23 (53.5)	29 (70.7)
C6-T1	1 (2.3)	0 (0.0)
Cage height, mm, mean ± SD
Proximal segment	6.3 ± 0.4	6.2 ± 1.1	0.766
Distal segment	6.3 ± 0.6	6.2 ± 1.3	0.858
Graft type
Autograft	41 (95.4)	0 (0.0)	< 0.0001
Allograft	0 (0.0)	40 (97.6)	< 0.0001
Both	2 (4.7)	1 (2.4)	1.000
Estimated blood loss, mL, mean ± SD	125.6 ± 129.9	101.7 ± 63.0	0.969
Surgery time, min, mean ± SD	199.6 ± 38.6	178.9 ± 34.7	0.014

Table 3

Clinical and radiographic outcomes by study group.

Outcomes	Integrated Spacer and Plate, n (%)	Anterior Spacer and Plate System, n (%)	P
Follow-up, mo, mean ± SD	14.1 ± 6.2	20.4 ± 10.5
Clinical scores, mean ± SD
Visual analog scale			0.432
Baseline	5.6 ± 2.5	6.3 ± 2.3
1 mo	4.8 ± 2.3	4.0 ± 3.1
3 mo	4.4 ± 2.1	3.2 ± 2.8
6 mo	4.6 ± 2.9	4.0 ± 3.1
1 y	5.0 ± 2.6	4.5 ± 2.9
2 y	5.3 ± 2.1	6.5 ± 2.4
Neck Disability Index			0.108
Baseline	26.9 ± 8.6	27.7 ± 9.1
1 mo	25.7 ± 8.1	20.0 ± 12.2
3 mo	23.5 ± 9.0	14.0 ± 13.5
6 mo	29.3 ± 7.5	18.5 ± 12.3
1 y	27.0 ± 10.4	20.9 ± 11.1
2 y	24.9 ± 11.1	24.3 ± 7.9
Radiographic findings
Proximal total fused	28 (73.7%)	33(84.6%)	0.272
Duration, mo, mean ± SD	8.3 ± 5.5	6.8 ± 5.4	0.092
Proximal (level 1)—total
1 mo	0 (0.)	1 (2.6)
3 mo	5 (16.1)	12 (33.3)
6 mo	14 (42.4)	13 (46.4)
1 y	7 (25.9)	5 (20.8)
2 y	2 (40.0)	2 (11.8)
Distal total fused	28 (73.7%)	33 (84.6%)	0.272
Duration, mo, mean ± SD	8.1 ± 5.5	7.0 ± 6.2	0.120
Distal (level 2)—total
1 mo	0 (0.0)	1 (2.6)
3 mo	6 (19.4)	13 (36.1)
6 mo	13 (39.4)	12 (31.6)
1 y	7 (25.9)	4 (16.7)
2 y	2 (40.0)	3 (17.7)
Proximal or distal duration, mo, mean ± SD	8.2 ± 5.5	7.1 ± 6.1	0.138

Table 4

Adverse events by study group.

Adverse Event	Integrated Spacer and Plate, n	Anterior Spacer and Plate System, n
Dysphagia	10	7
Persistent (>3 mo)	1	1
Durotomy	1	0
Horner syndrome	0	2
Infection
Superficial	2	0
Deep	0	0
Additional surgery	3	1
Pseudofusion	0	1
Neurapraxia	0	1