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

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.