Retrospective Analysis of Sagittal Balance Parameters and Clinical Efficacy After Short-Segment Anterior Cervical Spine Surgery with Different Fusion Devices

Wei, Zihan; Zhang, Ying; Yang, Sizhen; Cai, Chenhui; Ye, Jiawen; Qiu, H.; Xu, Huibin; Qu, Yiyun; Wang, Xuan; Chu, Tongwei

doi:10.2147/ijgm.s340877

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…The recovery of cervical lordosis relieves axial pain, improving the long-term e cacy [13] . The restoration of intervertebral height is to enlarge the area of the canal, so that the nerve root is free from compression.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the long-term efficacy of ROI-C and conventional cage-plate in treatment of spinal cord injury without fracture or dislocation: a retrospective study

Lu,

Li,

Wang

et al. 2023

Preprint

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Background The self-locking cage (ROI-C, LDR, Troyes, France) has been clinically applied in treating cervical degenerative disc disease (CDDD). However, only a few long-term clinical and radiographic studies have been performed in the treatment of spinal cord injury without fracture or dislocation (SCIWFD) so far. A comparison between ACDF with either ROI-C or CCP was performed to determine the better treatment for SCIWFD. Methods A total of 83 patients who underwent ACDF using either ROI-C or CCP were reviewed for radiological and clinical outcomes. There are 60 males and 23 females, aged between 32 and 88 years old, with an average age of 58.23 years. All patients had symptoms of nerve injury, including limb numbness, muscle weakness, hypoesthesia or urinary dysfunction. Preoperative ASIA classification of spinal nerve function: 7 cases of grade A, 23 cases of grade B, 34 cases of grade C and 19 cases of grade D were included in the study. Results 48 patients underwent ACDF with ROI-C and 35 patients with conventional cage-plate. They were studied with a follow-up of 28.63 ± 17.41 months and 29.48 ± 15.43 months respectively. No significant difference was found in blood loss, JOA and ASIA between the two groups. No significant difference was found in cervical lordosis (CL) (P > 0.05). Statistical difference was found in disc height of fused segment and T1 slope between the two groups (P < 0.05). No statistical difference was in the incidence of cage subsidence (P > 0.05). There was significant difference in the incidence of dysphagia. Both of two groups achieved bony fusion at final follow-up. Conclusion Our study demonstrated that ROI-C has the same efficacy as CCP in improving the cervical stability in treatment of SCIWFD. The migration of cage didn’t occur in ROI-C group at final follow-up, showing steadily fixed in cervical column. Moreover, the ROI-C does have the advantages of good therapeutic effect, mis-invasive, shorter operation time and fewer complications.

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Section: Discussionmentioning

confidence: 99%

Comparison of the long-term efficacy of ROI-C and conventional cage-plate in treatment of spinal cord injury without fracture or dislocation: a retrospective study

Lu,

Li,

Wang

et al. 2023

Preprint

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“…However, as the length of follow-up time has increased, some researchers have raised concerns about the increasing use of ZP devices [7,13,25]. Plenty of previous studies on the discussion of safety and efficacy were based on results compared between pre-and postoperative time points, leading to the evidence gap in long-term changes of cervical alignment [13].…”

Section: Discussionmentioning

confidence: 99%

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

et al. 2022

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Background Anterior cervical diskectomy and fusion (ACDF) has been widely accepted as a gold standard for patients with cervical spondylotic myelopathy (CSM). However, there was insufficient evidence to compare the changes in the cervical alignment with different fusion devices in a long follow-up period. This meta-analysis was performed to compare the radiologic outcomes and loss of correction (LOC) in cervical alignment of Zero-profile (ZP) device versus cage-plate (CP) construct for the treatment of CSM. Methods Retrospective and prospective studies directly comparing the outcomes between the ZP device and CP construct in ACDF were included. Data extraction was conducted and study quality was assessed independently. A meta-analysis was carried out by using fixed effects and random effects models to calculate the odds ratio and mean difference in the ZP group and the CP group. Results Fourteen trials with a total of 1067 participants were identified. ZP group had a lower rate of postoperative dysphagia at the 2- or 3-month and 6-month follow-up than CP group, and ZP group was associated with a decreased ASD rate at the last follow-up when compared with the CP group. The pooled data of radiologic outcomes revealed that there was no significant difference in postoperative and last follow-up IDH. However, postoperative and last follow-up cervical Cobb angle was significantly smaller in the ZP group when compared with the CP group. In subgroup analyses, when the length of the last follow-up was less than 3 years, there was no difference between two groups. However, as the last follow-up time increased, cervical Cobb angle was significantly lower in the ZP group when compared with the CP group. Conclusion Based on the results of our analysis, the application of ZP device in ACDF had a lower rate of postoperative dysphagia and ASD than CP construct. Both devices were safe in anterior cervical surgeries, and they had similar efficacy in correcting radiologic outcomes. However, as the last follow-up time increased, ZP group showed greater changes cervical alignment. In order to clarify the specific significance of LOC, additional large clinical studies with longer follow-up period are required.

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Does Screw Number of Zero‐profile Implants in Fusion Segment Influence Intervertebral Stability?

Peng,

Deng,

Sheng

et al. 2024

Orthopaedic Surgery

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ObjectiveThe unclear clinical outcomes of two different zero‐profile implants with different number of screws in hybrid surgery restricts the choice of patient‐specific implants. This study aims to compare two different implants on its postoperative subsidence, motion stabilization and clinical outcomes. It also provides references to the most reasonable implant choice in fusion surgery.MethodsThis was a retrospective study. From February 2014 to March 2022, 173 patients who underwent hybrid surgery were included. Among them, 122 received surgery with a four screw implant, while 51 received a two screw implant. We analyzed the significance of patient‐specific factors, radiographic factors and clinical outcomes. The Wilcoxon rank sum test, t tests/analysis of variance (ANOVA) test and stepwise multivariate logistic regression were adopted for statistical analysis.ResultsNo statistically significant difference was observed between the two screw and four screw groups in terms of immediate, middle, and long‐term stability and fusion rate (p > 0.05). However, the two screws group had higher FSU height subsidence at 3, 6, and 12 months postoperatively and higher rates of significant subsidence at three and 6 months postoperatively (p < 0.05). Both groups showed significant clinical improvements at the final follow‐up.ConclusionTwo screw and four screw implants provide comparable stability, fusion rates and clinical outcomes. However, the two screw implant was inferior to the four screw implant in subsidence prevention. Therefore, the two‐screw implant is non‐inferior to the four‐screw implant in most patients. It can be used as the priority choice in the fusion segment by its easy manageability. However, the patients with a high risk of subsidence such as multilevel surgery, the elderly, lower BMD, bad cervical alignment should receive a four screw implant rather than a two screw implant.

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Retrospective Analysis of Sagittal Balance Parameters and Clinical Efficacy After Short-Segment Anterior Cervical Spine Surgery with Different Fusion Devices

Cited by 4 publications

References 24 publications

Comparison of the long-term efficacy of ROI-C and conventional cage-plate in treatment of spinal cord injury without fracture or dislocation: a retrospective study

Comparison of the long-term efficacy of ROI-C and conventional cage-plate in treatment of spinal cord injury without fracture or dislocation: a retrospective study

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

Does Screw Number of Zero‐profile Implants in Fusion Segment Influence Intervertebral Stability?

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