Clinical study of Zero-P intervertebral fusion device in the treatment of cervicothoracic junction disc herniation

English Keywords:Cervicothoracic junction  Disc herniation  Zero-P intervertebral fusion device  Anterior decompression

English Abstract:

  【Abstract】 Objectives: To explore the application and efficacy of Zero-P internal fusion device in anterior cervicothoracic junction surgery. Methods: 9 patients in total with cervicothoracic junction disc herniation treated with Zero-P internal fusion device from August 2012 to August 2015 in our hospital were reviewed. There were 4 females and 5 males. The average age was 49.65±5.73 years old(range, 34-69 years). The average course of disease was 5.37±3.63 month(range, 3-18 months). CT and MRI showed that there were multi-segmental intervertebral disc herniation and compression of spinal cord evidently in 5 patients(2 patients located in C4/5 and C7/T1; 2 patients located in C6/7 and C7/T1; and one patient located in C3/4, C4/5 and C7/T1). Four patients were only affected in a single segment(C7/T1). Preoperative X-ray, CT and MRI showed that all patients′ sternal notches were below the affected level vertically. The effect of clinical treatments were evaluated by Japanese Orthopedic Association(JOA) score, visual analogue scale(VAS) and neck disability index(NDI). Bone graft fusion was evaluated by postoperative routine imaging examination. Results: All surgeries were performed successfully and the involved segaments were decompressed thoroughly. The decompression and implantation were performed smoothly. There was no severe intraoperative or postoperative complication, such as injury of spinal cord or dura, leakage of cerebrospinal fluid or infection. The average follow-up period was 24 months(range, 12－36 months) with a median of 25 months. The VAS was improved from preoperative 7.06±1.64 to 2.02±1.38 at 12 months after surgery. The NDI was improved from preoperative 43.27±4.53 to 8.64±2.37 at 12 months after surgery. The JOA score was improved from preoperative 6.94±1.57 to 13.14±1.62 at 12 months after surgery, the difference was statistically significant(P<0.05). There was no postoperative complications such as the subsidence, bolt loose, breakage or relocation of implants in X-rays during follow-up. All patients achieved bony fusion at final follow-up. Conclusions: The application of anterior cervical decompression combined with Zero-P intervertebral fusion device for the treatment of cervicothoracic junction disc herniation will come to an ideal decompression and fixation with a satisfactory clinical result.