Early outcome of anterior cervical discectomy and fusion using a Zero-profile interbody fusion and fixation device for cervical spondylosis

English Keywords:Cervical spondylosis  Anterior cervical discectomy and fusion  Zero-profile interbody fusion and fixation device  Outcome  Dysphagia

English Abstract:

  【Abstract】 Objectives： To analyze the early outcome of anterior cervical discectomy and fusion(ACDF) using a Zero-profile interbody fusion and fixation device(Zero-P) for interbody fusion in the treatment of cervical spondylosis. Methods： The study enrolled thirty-nine patients who underwent ACDF with Zero-P between June and October 2010. The cohort had a mean age of 50.3 years(range 33-71 years). There were 8 patients with radiculopathy and 31 patients with myelopathy. A total of 71 Zero-Ps were implanted, distributed as 14 patients with monosegmental, 18 patients with bisegmental, and 7 patients with trisegmental disease. The number of Zero-Ps implanted in the C3/4, C4/5, C5/6, C6/7 was 8, 19, 30, and 14 respectively. Clinical outcome was evaluated using Visual Analog Scales(VAS) score for radiculopathy, and Japanese Orthopaedic Association(JOA) score for myelopathy before operation and at 2 months′ and 12 months′ follow-up, while the cervical Cobb angle was measured by the tangent of the posterior body line of C2 and C7 on the lateral X-ray plain. The incidence and duration of dysphagia were also recorded. The abnormal activity at the surgical segment was observed by the extension and flexion lateral X-ray plain. Results： The operation time was between 48 and 130min(averagely 86min), and blood loss was between 40 and 310ml(averagely 110ml). Among 14 patients who had dysphagia within 1 week after operation, 13 patients′ symptom disappeared at 2 months′ follow-up， only 1(2.6%) patient′s symptom lasted for 4 months. All patients were followed up for an average of 14.6 months(range, 12 and 16 months）. Compared to preoperation, the VAS score reduced significantly(P<0.05) from preoperative 7.3±1.3 to 1.5±0.8 of 2 months′ follow-up and 1.3±0.9 of 12 months′ follow-up, the JOA score increased significantly(P<0.05) from preoperative 9.7±1.7 to 14.6±1.1 of 2 months′ follow-up and 15.0±1.2 of 12 months′ follow-up, and the cervical Cobb angle improved significantly(P<0.05) from preoperative 9.0°±10.0° to 18.4°±9.6° of 2 months′ follow-up and 17.8°±9.2° of 12 months′ follow-up. During the follow-up, no abnormal activity at the surgical segment and implant displacement were observed. Conclusions： The early outcome of ACDF using a Zero-profile interbody fusion and fixation device in the treatment of cervical spondylosis is satisfactomy and reliable, and can restore the cervical alignment. The incidence of postoperative dysphagia is low.