Clinical efficacy of a new type of door-shaped steel plate in anterior cervical discectomy and fusion

English Keywords:Cervical spondylosis  Anterior cervical discectomy and fusion  Door-shaped steel plate  Efficacy

English Abstract:

  【Abstract】 Objectives: To investigate the clinical efficacy of a new type of door-shaped steel plate in anterior cervical discectomy and fusion(ACDF). Methods: The clinical data of 46 patients with single-level cervical spondylosis treated with ACDF in our hospital between November 2020 and January 2022 were retrospectively analyzed, including 29 patients of cervical spondylotic radiculopathy and 17 patients of cervical spondylotic myelopathy. Among the patients, 25 were fixed with the new type of door-shaped steel plate(observation group), consisting of 18 males and 7 females, aged 58.46±6.04 years(range, 42-67 years), and the operative segment was C4/5 in 7 cases, C5/6 in 12 cases, and C6/7 in 6 cases; The other 21 patients were treated with Katia anterior cervical internal fixation system(control group), including 13 males and 8 females, aged 58.31±5.79 years(45-71 years), and the operative segment was C4/5 in 5 cases, C5/6 in 10 cases, and C6/7 in 6 cases. There was no significant difference in age, gender, and lesion segment between the two groups(P>0.05). The intraoperative blood loss, operation time, postoperative complications(hoarseness and dysphagia, etc.) of the two groups were recorded. The visual analogue scale(VAS), Japanese Orthopaedic Association(JOA) score of cervical spine, and neck disability index(NDI) before operation, at 3d and 3 months and, the last follow-up were used to evaluate the effectiveness. The cervical Cobb angle was measured on the X-ray films before operation, at 1 week, and 3 and 6 months after operation, and the fusion rate of bone graft was observed on the X-ray film at 6 months after operation. Results: The operation time and intraoperative blood loss were 108.6±14.0min and 52.8±23.0ml in the observation group, and 124.3±14.6min and 60.9±18.6ml in the control group. The operation time in the observation group was shorter than that in the control group(P<0.05), and there was no significant difference in intraoperative blood loss between the two groups(P>0.05). In the observation group, none occurred hoarseness while 2 cases experienced dysphagia after operation; In the control group, 1 patient occurred hoarseness and 3 patients experienced dysphagia after operation. There was no significant difference in the proportion of hoarseness or dysphagia between the two groups(P>0.05). All the 46 patients were followed up for 6-14 months. The VAS score, JOA score, and NDI at 3d and 3 months after operation, and final follow-up were significantly improved when compared with those before operation in the two groups(P<0.05), but there was no significant difference between the two groups at the same time point(P>0.05). The cervical Cobb angles of the two groups at 1 week, 3 months and 6 months after operation were significantly improved when compared with those before operation(P<0.05), but no significant difference was found between the two groups at the same time point(P>0.05). Good intervertebral fusion was observed in 21 cases(84.0%) in the observation group and 18 cases(85.7%) in the control group at 6 months after operation, with no significant difference between the two groups(P>0.05). Conclusions: In the treatment of single-level cervical spondylosis with ACDF, the new type of door-shaped steel plate and Katia anterior cervical internal fixation system have similar clinical effects, but with the integration of screw, the new type of door-shaped steel plate is easy to operate and shorter in operation time.