Outcome evaluation of zero-profile implant compared with an anterior plate and cage used in anterior cervical discectomy and fusion: a two-year follow-up study

Zhang, Liang; Wang, Jingcheng; Tao, Yajun; Feng, Xinmin; Yang, Jiandong; Zhang, Shengfei

doi:10.5137/1019-5149.jtn.12017-14.1

Cited by 11 publications

(14 citation statements)

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“…In accordance to other clinical series with similar samples and follow-up periods [ 17 - 19 ], our data demonstrated that there was statistically significant postoperative improvement of the NDI score. It has been postulated that the postoperative pain reduction is strongly associated with the patient’s satisfaction [ 14 , 20 ].…”

Section: Discussionsupporting

confidence: 92%

“…There are several studies in the literature examining the effect of ACDF with a PEEK cage in the management of cervical lordosis. They resulted in significant lordosis restoration postoperatively that was maintained throughout the final follow-up (12 - 24 months) [ 16 - 19 ]. Contrariwise, our results showed that there was a slight increase of the mean Cobb angle in neutral immediately after surgery, which however was lost during the 12-month follow-up period ( Table 5 ).…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage

et al. 2018

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BackgroundAnterior cervical discectomy and fusion (ACDF) with a polyetheretherketone (PEEK) cage is considered as the gold standard for patients with cervical disc disease. However, there are limited in vivo data on the impact of ACDF on the cervical kinematics and its association with patient-reported clinical outcomes. The purpose of this study was to investigate the impact of altered cervical sagittal alignment (cervical lordosis) and sagittal range of motion (ROM) on patients’ self-reported pain and functional disability, after ACDF with a PEEK cage.MethodsWe prospectively studied 74 patients, who underwent single-, or consecutive two-level ACDF with a PEEK interbody cage. The clinical outcomes were assessed by using the pain numeric rating scale (NRS) and the neck disability index (NDI). Radiological outcomes included cervical lordosis and C2-C7 sagittal ROM. The outcome measures were collected preoperatively, at the day of patients’ hospital discharge, and also at 6 and 12 months postoperatively.ResultsThere was a statistically significant reduction of the NRS and NDI scores postoperatively at each time point (P < 0.005). Cervical lordosis and also ROM significantly reduced until the last follow-up (P < 0.005). There was significant positive correlation between NRS and NDI preoperatively, as well as at 6 and 12 months postoperatively (P < 0.005). In regard to the ROM and the NDI scores, there was no correlation preoperatively (P = 0.199) or postoperatively (6 months, P = 0.322; 12 months, P = 0.476). Additionally, there was no preoperative (P = 0.134) or postoperative (6 months, P = 0.772; 12 months, P = 0.335) correlation between the NDI scores and cervical lordosis.ConclusionsIn our study, reduction of cervical lordosis and sagittal ROM did not appear to significantly influence on patients’ self-reported disability. Such findings further highlight the greater role of pain level over the mechanical limitations of ACDF with a PEEK cage on patients’ own perceived recovery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage

et al. 2018

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“…Osteoporosis has also no significant impact on GSP development after the implantation of anchored cage 15 . Numerous studies have found no differences in GSP development when comparing the effects of implanted Zero-P ® cage and cage fixed by the conventional cervical plate 3,14,16,17 . Son et al however refer a more significant global lordotisation after the implantation of the anchored cage in comparison to a cage fixed by the conventional plate 18 .…”

Section: Discussionmentioning

confidence: 99%

Change in sagittal profile after implantation of anchored interbody cage in the surgical procedure for degenerative cervical spine disease

Opšenák¹,

Hanko²,

Snopko³

et al. 2021

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. The aim of this study was to verify the relationship between changes in the segmental sagittal profile (SSP) and changes in the global sagittal profile (GSP) after anterior cervical discectomy with anchored cage implantation (ACDF). Study design. Prospective study with 2-year follow-up. Methods. This study includes 104 patients after 1-level or 2-level ACDF operated between the May 2013 and March 2016. SSP was evaluated by Cobb angle measurement of operated motion segment (CobbS) and GSP was evaluated by Cobb angle measurement in C2-C7 segments (CobbG). Both SSP and GSP were measured pre-and postoperatively within a 24 months follow-up period. The influence of factors such as age, gender, number of treated segments and osteoporosis was evaluated using t-tests. The correlation between SSP and GSP changes was assessed by Pearson's correlation coefficient. Results. In the early postoperative period after 1-level ACDF, there was a significantly greater increase in CobbS compared to that of the 2-level ACDF (P=0.0149). Male patients experienced a significant decrease of CobbG during the first 6 months after surgery as well as patients with osteoporosis within 12 months after ACDF. After ACDF the SSP change weakly correlated with the GSP change. Conclusion. SSP change after 1-or 2-level ACDF correlates mostly weakly with GSP change. Male gender and osteoporosis were identified as risk factors for global lordotisation following ACDF.

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“…The advantages of cage and plate constructs include a higher fusion rate, disc height restoration, as well as better cervical lordosis, and alignment 29) . However, using cage and plate constructs involves a further risk of hardware-related operative and postoperative complications, such as screw or plate displacement, soft tissue damage, esophageal perforation, and chronic dysphagia, which have been reported particularly if bulky plates are used 31) . In addition, placing of an oversized plate close to the adjacent level may increase the rate of adjacent level ossification 3) .…”

Section: Discussionmentioning

confidence: 99%

Subsidence after Anterior Cervical Interbody Fusion Using a Zero-Profile Device

Kang¹,

Oh²,

Cho³

2019

Nerve

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Zero-profile device (Zero-P) has generally been used as a stand-alone cage in anterior cervical discectomy and fusion (ACDF). However, using Zero-P has been reported to be associated with a high subsidence rate. The present study evaluates the factors that influence the subsidence of ACDF. Methods: Records of a total of 29 patients with degenerative spondylosis resulting in radiculopathy or myelopathy between C2 and C7 who underwent ACDF with Zero-P were retrospectively reviewed. The participants received 1 or 2 level ACDF with Zero-P in our clinic from December, 2011 to December, 2017. A total of 35 treatment levels were included in the analysis. Subsidence was defined when anterior segmental heights decreased by more than 2 mm during the follow-up period. The patients were divided into the subsidence and non-subsidence groups. The following factors were investigated in relation to the occurrence of subsidence: age, gender, body mass index, diabetes mellitus, cage height, perioperative distraction, segmental lordosis, pain score, fusion grade, anterior/posterior segmental height ratio, and cage distance. Results: Cage subsidence was observed in 15 cases (15/35, 42%). Cage distance at immediate postoperation was significantly different between the 2 groups; specifically, while the group with subsidence had 2.66±1.62 mm distance, the group without subsidence had 1.24±1.13 mm distance (p=0.008). Conclusion: This study confirms that the more deeply titanium part is inserted at the anterior edge, the more subsidence occurs. In order to decrease the occurrence of cage subsidence, Zero-P cages should be located the closest possible to the anterior rim of vertebral body at operation.

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Outcome evaluation of zero-profile implant compared with an anterior plate and cage used in anterior cervical discectomy and fusion: a two-year follow-up study

Abstract: ABSTRACTanterior plate to enhance the stability to reduce graft-related complications and increase fusion rates (11,24).

Cited by 11 publications

References 30 publications

Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage

Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage

Change in sagittal profile after implantation of anchored interbody cage in the surgical procedure for degenerative cervical spine disease

Subsidence after Anterior Cervical Interbody Fusion Using a Zero-Profile Device

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