Risk Factors of Nonfusion after Anterior Cervical Decompression and Fusion in the Early Postoperative Period: A Retrospective Study

Peng, Zihan; Liu, Li; Sheng, Xia-Qing; Liu, Hao; Ding, Chen; Wang, Beiyu; Hong, Ying; Pan, Xiaoli; Meng, Yang

doi:10.1111/os.13835

Cited by 3 publications

(1 citation statement)

References 50 publications

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“…All surgical procedures were performed by one senior spinal surgeon in our department using a standard, right Smith- Robinson approach after the induction of general anesthesia ( 30 , 31 ). The selection of the zero-profile device or PCC device was based on the patient’s condition and willingness.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the effectiveness of zero-profile device and plate cage construct in the treatment of one-level cervical disc degenerative disease combined with moderate to severe paraspinal muscle degeneration

Abudouaini,

Xu,

Yang

et al. 2023

Front. Endocrinol.

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ObjectiveRecent evidence indicates that cervical paraspinal muscle degeneration (PMD) is a prevalent and age-related condition in patients with cervical disc degenerative disease (CDDD). However, the relationship between surgery selection and post-operative outcomes in this population remains unclear. Consequently, this study aims to investigate the disparities in clinical outcomes, radiological findings, and complications between two frequently utilized anterior cervical surgical procedures. The objective is to offer guidance for the management of PMD in conjunction with CDDD.MethodsA total of 140 patients who underwent single-level anterior cervical discectomy and fusion (ACDF) at our department were included in this study. The patients were divided into three groups based on the severity of PMD: mild (n=40), moderate (n=54), and severe (n=46), as determined by Goutalier fat infiltration grade. The subjects of interest were those with moderate-severe PMD, and their clinical outcomes, radiological parameters, and complications were compared between those who received a stand-alone zero-profile anchored cage (PREVAIL) and those who received a plate-cage construct (PCC).ResultsThe JOA, NDI, and VAS scores exhibited significant improvement at all postoperative intervals when compared to baseline, and there were no discernible differences in clinical outcomes between the two groups. While the PCC group demonstrated more pronounced enhancements and maintenance of several sagittal alignment parameters, such as the C2-7 angle, FSU angle, C2-7 SVA, and T1 slope, there were no statistically significant differences between the two groups. The incidence of dysphagia in the zero-profile group was 22.41% at one week, which subsequently decreased to 13.79% at three months and 3.45% at the final follow-up. In contrast, the plate cage group exhibited a higher incidence of dysphagia, with rates of 47.62% at one week, 33.33% at three months, and 11.90% at the final follow-up. Notably, there were significant differences in the incidence of dysphagia between the two groups within the first three months. However, the fusion rate, occurrence of implant subsidence, and adjacent segment degeneration (ASD) were comparable at the final follow-up.ConclusionFor patients with one-level cervical disc degenerative disease combined with paraspinal muscle degeneration, both the zero-profile technique and PCC have demonstrated efficacy in ameliorating clinical symptoms and maintaining the postoperative sagittal balance. Although no significant disparities were observed between these two technologies in terms of complications such as adjacent segment degeneration and implant subsidence, the zero-profile technique exhibited superior performance over PCC in relation to dysphagia during the early stages of postoperative recovery. To validate these findings, studies with longer follow-up periods and evaluations of multilevel cervical muscles are warranted.

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Section: Methodsmentioning

confidence: 99%

Comparison of the effectiveness of zero-profile device and plate cage construct in the treatment of one-level cervical disc degenerative disease combined with moderate to severe paraspinal muscle degeneration

Abudouaini,

Xu,

Yang

et al. 2023

Front. Endocrinol.

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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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Factors Predicting Health-Related Quality of Life among People with Cervical Spondylosis Undergoing Anterior Cervical Discectomy and Fusion: A Cross-sectional

Cai,

Lertwatanawilach,

Fongkaew

et al. 2024

PRIJNR

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Cervical spondylosis affects many people worldwide and is a natural age-related disease associated with degenerative changes within the intervertebral disc. Despite the efficacy of anterior cervical discectomy and fusion, people who undergo this operation can experience various symptoms that impact their health-related quality of life. Developing effective programs to improve health-related quality of life requires understanding the factors that predict it in this population. This cross-sectional study aimed to determine the health-related quality of life in people with anterior cervical discectomy and fusion and identify factors predicting the physical and mental components of health-related quality of life. This study had a convenience sample of 308 adults and older adults post-anterior cervical discectomy and fusion in Shanghai City, China. The data were collected through an online survey platform when participants were discharged. The research instruments included the Eating Assessment Tool-10, the Neck Disability Index, the Short Form Geriatric Depression Scale, the Multidimensional Scale of Perceived Social Support, and the Short Form Health Survey Version 1. Data analysis used descriptive statistics, Pearson’s correlation, and hierarchical multiple regression. The findings revealed a moderate level of health-related quality of life among people with anterior cervical discectomy and fusion. Remaining disability and depression could explain 46.50% of the variance in the physical component of the health-related quality of life. In contrast, smoking, gender, social support, depression, and remaining disability could explain 48.40% of the variance in the mental health component. The findings are useful for health professionals, including nurses, in designing comprehensive programs based on these factors to help people with anterior cervical discectomy and fusion to improve both the physical and mental health components of their quality of life. However, it is recommended that this study be replicated with different samples in different locations.

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Risk Factors of Nonfusion after Anterior Cervical Decompression and Fusion in the Early Postoperative Period: A Retrospective Study

Cited by 3 publications

References 50 publications

Comparison of the effectiveness of zero-profile device and plate cage construct in the treatment of one-level cervical disc degenerative disease combined with moderate to severe paraspinal muscle degeneration

Comparison of the effectiveness of zero-profile device and plate cage construct in the treatment of one-level cervical disc degenerative disease combined with moderate to severe paraspinal muscle degeneration

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

Factors Predicting Health-Related Quality of Life among People with Cervical Spondylosis Undergoing Anterior Cervical Discectomy and Fusion: A Cross-sectional

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