Clinical effects of Zero-p vs traditional titanium plate for anterior cervical discectomy and fusion

English Keywords:Cervical spondylotic myelopathy  Intervertebral fusion device  Internal fixation  Efficacy

English Abstract:

  【Abstract】 Objectives: To compare the clinical effects between Zero-p and traditional titanium plate with cage in treating cervical spondylotic myelopathy. Methods: The clinical data of 46 patients with cervical spondylotic myelopathy who underwent anterior cervical discectomy and fusion(ACDF) by Zero-p implant(group A, n=22) or traditional titanium plate with cage(group B, n=24) between January 2010 and October 2011 were retrospectively analyzed. There was no statistical significance of the age, the gender, preoperative JOA scores, and the surgical level between two groups(P>0.05). The intraoperative blood loss, operation time, postoperative JOA scores and JOA recovery rate, fusion rate, dysphagia incidence and incidence of adjacent segment degeneration in both groups were measured and compared. Results: In group A: the operation time was 97.3min, and the intraoperative blood loss was 86.4ml; while in group B: the operation time was 103.5min, and the intraoperative blood loss was 90.6ml. There were no significant differences with respect to the operation time and intraoperative blood loss between two groups(P>0.05). 1 patient in group A and 8 in group B suffered from dysphagia after operation, which showed significant differece between two groups(P<0.05). The follow-up for group A was 12-31 months(mean, 21.5 months), and 13-32 months(mean, 22.1 months) for group B, which showed no significant difference(P>0.05). The JOA scores improved significantly after operation in both groups(P<0.01), with the JOA improvement rate in group A and B of 60.9% and 62.6% respectively, which showed no statistical signficance between two groups(P>0.05). All surgical levels fused well after operation. Among the 44 adjacent levels in group A, 4 discs developed degeneration or progressive degeneration in MRI; among the 48 adjacent levels in group B, 8 discs developed degeneration or progressive degeneration, which showed no statistical signficance either for the fusion rate or adjacent level degeneration rate(P>0.05). Conclusions: Zero-p implant and traditional titanium plate with cage have similar effective treatments for single level cervical spondylotic myelopathy, while Zero-p implant has lower incidence of dysphagia.