Zero-profile interbody fusion in single and two-level anterior cervical discectomy and fusion: a novel surgical system and its indications

Abstract: Anterior cervical discectomy and fusion (ACDF) is considered gold standard for anterior management of cervical degenerative disease, yet traditional interbody and plate constructs often require substantial soft-tissue exposure and may be associated with increased postoperative morbidity and dysphagia/prevertebral swelling. Moreover, anterior plate prominence and prolonged retraction have been implicated in postoperative dysphagia and prevertebral soft-tissue irritation, motivating interest in low-profile fixation strategies. The goal of this paper is to introduce a novel zero-profile interbody fusion technology and describe its clinical application in the context of 1- and 2-level ACDF. Specifically, this paper aims to: (I) define indications for use of this novel zero-profile interbody fixation system; (II) detail the step-by-step surgical technique with tips/tricks and other technical pearls; and (III) discuss advantages of this system relative to traditional interbody devices and plate-based constructs. Overall, this novel implant combines a biocompatible polymer interbody spacer with integrated titanium fixation, enabling stable anterior column support and an all-in-one construct designed to remain fully contained within the disc space footprint while maintaining construct stability and arthrodesis principles. Overall, this novel technique enables efficient intraoperative implantation, reduced soft-tissue retraction, especially in revision cases that conventionally necessitate plate removal or in adjacent-segment settings where prior anterior hardware may complicate exposure. Because this report is intended as a surgical technique description rather than a clinical outcomes study, any proposed benefits related to dysphagia, operative time, or fusion should be interpreted cautiously and warrant prospective comparative evaluation. Overall, it represents a safer, quicker and easy-to-adopt advancement in anterior cervical fusion technology that may streamline workflow while minimizing anterior profile.