Early clinical observation of stand-alone zero-profile interbody fusion system in the surgical treatment of cervical spine disease
LI Zhong-hai
TANG Jia-guang
REN Dong-feng
WANG Hua-dong
GUO Ji-dong
LI Li
WU Wen-wen
HOU Shu-xun
Abstract：Objective To investigate the early clinical outcomes of anterior cervical discectomy and fusion ( ACDF ) with stand-alone zero-profile interbody fusion system in the treatment of degenerative cervical disc disease, and to evaluate the safety and efficacy. Methods Between November 2012 and December 2014, 73 cases of degenerative cervical disc disease underwent ACDF with stand-alone zero-profile interbody fusion system, including 23 cases of cervical spondylotic myelopathy, 40 cases of cervical spondylotic radiculopathy and 5 cases of mixed type. The other 5 cases were excluded because they had not completed their 1-year follow-up. There were 41 males and 27 females, whose mean age was 53.4 years ( range: 35 - 68 years ). There were 32 cases at 1-level, 21 cases at 2-level, 11 cases at 3-level and 4 cases at 4-level, with 123 levels in total. The clinical evaluation included modified Japanese Orthopedic Association ( mJOA ) scale, neck disability index ( NDI ) and visual analogue scale ( VAS ) before surgery, at 2 days and 3 months after surgery and at the final follow-up. The postoperative complications related to dysphagia were assessed using the Bazaz score. Disc height index ( DHI ) at fused level, Cobb angle of lordosis from C2 to C7 and complications related to internal fixation were measured and compared on anteroposterior, lateral and flexion-extension X-rays. According to Pitzen's criteria, intervertebral fusion was evaluated. The adjacent level degeneration was noted according to Miyazaki classification on MRI images. Results All the 68 cases were followed up for 20.8 months on average ( range: 12 - 36 months ). The mJOA score was 7.6 ± 2.3 before surgery and 14.9 ± 0.6 at the final follow-up. The NDI score was 16.9 ± 3.0 before surgery and 10.7 ± 2.1 at the final follow-up. The VAS score was 6.0 ± 1.7 before surgery and 1.8 ± 0.7 at the final follow-up. The DHI at fused level was ( 6.1 ± 1.8 ) mm before surgery and ( 6.8 ± 0.8 ) mm at the final follow-up. The Cobb's angle of C2-7 was ( 10.8 ± 2.3 ) ° before surgery and ( 14.0 ± 1.5 ) ° at the final follow-up. The above-mentioned results showed statistical significance ( P < 0.05 ). Among 5 cases who had dysphagia within 2 days after operation, 3 was mild, 1 was moderate and 1 was severe. Symptomatic treatment was conducted. The symptoms disappeared in all the 5 cases within 3 months after the treatment. There were no complications such as fixator loosening, breakage or shifting. Radiographic evaluation revealed that bone fusion rate was 93.5% and cage subsidence rate was 9.76% at the final follow-up. Four cases ( 9.8% ) showed new signs of degeneration adjacent to the fused segment. Conclusions This study shows that the early clinical outcomes of ACDF with stand-alone zero-profile interbody fusion system for degenerative cervical disc disease are satisfactory, with the advantages of simple operation, short operation time, less blood loss, good stability, small trauma and lower incidence of postoperative dysphagia. The intervertebral height can be effectively recovered, and the postoperative complications related to internal fixation are rare. Nevertheless, a longer follow-up is needed to assess the functionality of the system and its influence on adjacent levels.
Keywords：Cervical spondylosisDecompressionsurgicalSpinal fusionDiskectomyStand-alone zero-profile interbody fusion system
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 362-368 )