Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

Abstract

ObjectiveThe zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. MethodsData from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients’ clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom’s criteria. ResultsThe C2–7 Cobb and operative segmental angles increased by 3.45±7.61 and 2.94±4.59 in group A; and 2.46±7.31 and 2.88±5.49 in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than “good” using Odom’s criteria. ConclusionThe application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

Anterior cervical discectomy and fusion with a zero-profile VA spacer device: a clinical and radiological study with two-year follow-up

“…The Zero-P spacer incorporates a plate and screw system, eliminating the inherent disadvantage of stand-alone cages, which is extension instability. A previous study has reported the use of Zero-P as internal fixation after a traumatic subaxial cervical disk injury, which might prove the biomechanical stability of this new device in vivo [ 25 ].…”

Factores de riesgo y prevalencia de la lesión medular en adultos: una revisión sistemática

“…También, las caídas predominan en diferentes estudios (Karaoz et al, 2019;Kabatas et al, 2018;Kim et al, 2018;Neyaz et al, 2020;Formentin et al, 2019;Sekine et al, 2018), esto podría deberse a que son la segunda causa de mortalidad no traumática, 684 .000 fallecen al día, estas son producidas en personas que trabajan en alturas, el consumo de alcohol y estupefacientes, patologías subyacentes, la edad, efectos adversos con ciertos medicamentos (Strassburguer et al, 2013;World Health Organization [OMS], 2021).…”

A Potentially Advantageous Use of a Zero-Profile, Stand-Alone Anterior Interbody Spacer at C2-3 for the Treatment of Hangman’s Fracture: A Technical Case Report

“…Brembilla et al reported the successful use of zero-profile devices in the single-surgery treatment of traumatic injuries, though the study only included injuries involving the C3-7 levels [ 15 ]. Kim et al published a series of 17 patients with traumatic disc injuries from C3-7 and encountered favorable clinical results comparable to those achieved in the treatment of conventional spondylosis with ACDF using a separate anterior plate [ 16 ].…”

“…This application of a stand-alone spacer is subject to the shortcomings and limitations of the technique compared with anterior fusion with a plate that have previously been described, including a potentially increased chance of implant subsidence, pseudoarthrosis, and loss of sagittal alignment [ 14 , 16 ]. In addition, there is a concern that trauma may be different from degenerative disease in that the former may be associated with greater potential instability that a stand-alone device would need to overcome.…”

“…Jumped facets and other injuries that are associated with extensive ligamentous disruption and instability may be less suitable for a stand-alone, zero-profile fixation than for Hangman’s fracture. However, Njoku et al and Kim et al noted that biomechanical studies appear to support the suitability of the technique even for traumatic indications and that the theoretical concerns regarding implant fixation strength have not manifested in any unfavorable clinical outcomes [ 14 , 16 ].…”