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Published in: European Spine Journal 1/2015

01-01-2015 | Original Article

The application of zero-profile anchored spacer in anterior cervical discectomy and fusion

Authors: Zhiwen Wang, Weimin Jiang, Xuefeng Li, Heng Wang, Jinhui Shi, Jie Chen, Bin Meng, Huilin Yang

Published in: European Spine Journal | Issue 1/2015

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Abstract

Purpose

We aimed to analyze the clinical efficacy of the zero-profile anchored spacers in the treatment of one-level or two-level cervical degenerative disc disease.

Methods

From April 2011 to April 2013, a total of 63 consecutive patients with cervical degenerative disc disease who underwent one- or two-level ACDF using either the zero-profile anchored spacer or the stand-alone cages and a titanium plate fixation were reviewed for the radiological and clinical outcomes and complications. The zero-profile anchored spacers were used in 30 patients (anchored group) and stand-alone cages with an anterior cervical plate were implanted in 33 cases (non-anchored group). Operative time, intraoperative blood loss, clinical and radiological results were compared between the anchored group and the non-anchored group.

Results

All patients were followed up for at least 12 months. There were not bolt loosening or rupture of anchoring clips, screws or titanium plates observed in two groups during follow-up period. There were no significant difference in neck disability index scores, Japanese Orthopedic Association scores, fusion rate, and cervical lordosis during follow-up between two groups (P > 0.05), but significant difference in the operation time, blood loss and the presence of dysphagia were found (P < 0.05). There were no adjacent disc degeneration and instability observed in two groups.

Conclusions

The zero-profile anchored spacer achieved similar clinical outcomes compared to ACDF with anterior plating for the treatment of the cervical degenerative disc disease. However, zero-profile anchored spacer was associated with a lower risk of postoperative dysphagia, shorter operation time, less blood loss, and relatively greater simplicity than the stand-alone cage with a titanium plate.
Literature
1.
go back to reference Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am 40(3):607–624PubMed Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am 40(3):607–624PubMed
2.
go back to reference Silber JS, Anderson DG, Daffner SD, Brislin BT, Hilibrand AS, Albert TJ (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 28(2):134–139CrossRef Silber JS, Anderson DG, Daffner SD, Brislin BT, Hilibrand AS, Albert TJ (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 28(2):134–139CrossRef
3.
go back to reference Fujibayashi S, Shikata J, Kamiya N, Tanaka C (2000) Missing anterior cervical plate and screws: a case report. Spine (Phila Pa 1976) 25(17):2258–2261CrossRef Fujibayashi S, Shikata J, Kamiya N, Tanaka C (2000) Missing anterior cervical plate and screws: a case report. Spine (Phila Pa 1976) 25(17):2258–2261CrossRef
4.
go back to reference Lowery GL, McDonough RF (1998) The significance of hardware failure in anterior cervical plate fixation. Patients with 2- to 7-year follow-up. Spine (Phila Pa 1976) 23(2):181–186 (discussion 186–187)CrossRef Lowery GL, McDonough RF (1998) The significance of hardware failure in anterior cervical plate fixation. Patients with 2- to 7-year follow-up. Spine (Phila Pa 1976) 23(2):181–186 (discussion 186–187)CrossRef
5.
go back to reference Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Robinson JS (2007) Anterior cervical discectomy and fusion associated complications. Spine Phila Pa (1976) 32(21):2310–2317CrossRef Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Robinson JS (2007) Anterior cervical discectomy and fusion associated complications. Spine Phila Pa (1976) 32(21):2310–2317CrossRef
6.
go back to reference Jung A, Schramm J, Lehnerdt K, Herberhold C (2005) Recurrent laryngeal nerve palsy during anterior cervical spine surgery: a prospective study. J Neurosurg Spine 2(2):123–127PubMedCrossRef Jung A, Schramm J, Lehnerdt K, Herberhold C (2005) Recurrent laryngeal nerve palsy during anterior cervical spine surgery: a prospective study. J Neurosurg Spine 2(2):123–127PubMedCrossRef
7.
go back to reference Orlando ER, Caroli E, Ferrante L (2003) Management of the cervical esophagus and hypofarinx perforations complicating anterior cervical spine surgery. Spine 28(15):E290–E295PubMed Orlando ER, Caroli E, Ferrante L (2003) Management of the cervical esophagus and hypofarinx perforations complicating anterior cervical spine surgery. Spine 28(15):E290–E295PubMed
8.
go back to reference Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine Phila Pa (1976) 27(22):2453–2458CrossRef Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine Phila Pa (1976) 27(22):2453–2458CrossRef
9.
go back to reference Yue WM, Brodner W, Highland TR (2005) Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5-to 11-year follow-up study. Eur Spine J 14(7):677–682PubMedCentralPubMedCrossRef Yue WM, Brodner W, Highland TR (2005) Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5-to 11-year follow-up study. Eur Spine J 14(7):677–682PubMedCentralPubMedCrossRef
10.
go back to reference Vernon H, Mior S (1991) The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 14(7):409–415PubMed Vernon H, Mior S (1991) The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 14(7):409–415PubMed
11.
go back to reference Yonenobu K, Okada K, Fuji T, Fujiwara K, Yamashita K, Ono K (1986) Causes of neurologic deterioration following surgical treatment of cervical myelopathy. Spine Phila Pa (1976) 11(8):818–823CrossRef Yonenobu K, Okada K, Fuji T, Fujiwara K, Yamashita K, Ono K (1986) Causes of neurologic deterioration following surgical treatment of cervical myelopathy. Spine Phila Pa (1976) 11(8):818–823CrossRef
12.
go back to reference Hirabayashi K, Miyakawa J, Satomi K, Maruyama T, Wakano K (1981) Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine Phila Pa (1976) 6(4):354–364CrossRef Hirabayashi K, Miyakawa J, Satomi K, Maruyama T, Wakano K (1981) Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine Phila Pa (1976) 6(4):354–364CrossRef
13.
go back to reference Hacker RJ, Cauthen JC, Gilbert TJ, Griffith SL (2000) A prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage. Spine Phila Pa (1976) 25(20):2646–2655CrossRef Hacker RJ, Cauthen JC, Gilbert TJ, Griffith SL (2000) A prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage. Spine Phila Pa (1976) 25(20):2646–2655CrossRef
14.
go back to reference Rao RD, Gourab K, David KS (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Joint Surg Am 88(7):1619–1640PubMedCrossRef Rao RD, Gourab K, David KS (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Joint Surg Am 88(7):1619–1640PubMedCrossRef
15.
go back to reference Vaccaro AR, Falatyn SP, Scuderi GJ, Eismont FJ, McGuire RA, Singh K, Garfin SR (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11(5):410–415PubMedCrossRef Vaccaro AR, Falatyn SP, Scuderi GJ, Eismont FJ, McGuire RA, Singh K, Garfin SR (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11(5):410–415PubMedCrossRef
16.
go back to reference Sahjpaul RL (2007) Esophageal perforation from anterior cervical screw migration. Surg Neurol 68(2):205–209PubMedCrossRef Sahjpaul RL (2007) Esophageal perforation from anterior cervical screw migration. Surg Neurol 68(2):205–209PubMedCrossRef
17.
go back to reference Smith-Hammond CA, New KC, Pietrobon R, Curtis DJ, Scharver CH, Turner DA (2004) Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures. Spine 29(13):1441–1446PubMedCrossRef Smith-Hammond CA, New KC, Pietrobon R, Curtis DJ, Scharver CH, Turner DA (2004) Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures. Spine 29(13):1441–1446PubMedCrossRef
18.
go back to reference Frempong-Boadu A, Houten JK, Osborn B, Opulencia J, Kells L, Guida DD, Roux PD (2002) Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech 15(5):362–368PubMedCrossRef Frempong-Boadu A, Houten JK, Osborn B, Opulencia J, Kells L, Guida DD, Roux PD (2002) Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech 15(5):362–368PubMedCrossRef
19.
go back to reference Lee MJ, Bazaz R, Furey CG, Yoo J (2005) Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech 18(5):406–409PubMedCrossRef Lee MJ, Bazaz R, Furey CG, Yoo J (2005) Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech 18(5):406–409PubMedCrossRef
20.
go back to reference Scholz M, Schnake KJ, Pingel A, Hoffmann R, Kandziora F (2011) A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res 469(3):666–673PubMedCentralPubMedCrossRef Scholz M, Schnake KJ, Pingel A, Hoffmann R, Kandziora F (2011) A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res 469(3):666–673PubMedCentralPubMedCrossRef
21.
go back to reference Dickerman RD, Reynolds AS, Morgan BC, Tompkins J, Cattorini J (2007) Bennett Mrh-BMP-2 can be used safely in the cervical spine: dose and containment are the keys! Spine J 7(4):508–509PubMedCrossRef Dickerman RD, Reynolds AS, Morgan BC, Tompkins J, Cattorini J (2007) Bennett Mrh-BMP-2 can be used safely in the cervical spine: dose and containment are the keys! Spine J 7(4):508–509PubMedCrossRef
22.
23.
go back to reference Kao FC, Niu CC, Chen LH, Lai PL, Chen WJ (2005) Maintenance of interbody space in one-and two-level anterior cervical interbody fusion: comparison of the effectiveness of autograft, allograft, and cage. Clin Orthop Relat Res 430:108–116PubMedCrossRef Kao FC, Niu CC, Chen LH, Lai PL, Chen WJ (2005) Maintenance of interbody space in one-and two-level anterior cervical interbody fusion: comparison of the effectiveness of autograft, allograft, and cage. Clin Orthop Relat Res 430:108–116PubMedCrossRef
24.
go back to reference Baba H, Furusawa N, Imura S, Kawahara N, Tsuchiya H, Tomita K (1993) Late radiographic findings after anterior cervical fusion for spondylotic myeloradiculopathy. Spine (Phila Pa 1976) 18(15):2167–2173CrossRef Baba H, Furusawa N, Imura S, Kawahara N, Tsuchiya H, Tomita K (1993) Late radiographic findings after anterior cervical fusion for spondylotic myeloradiculopathy. Spine (Phila Pa 1976) 18(15):2167–2173CrossRef
25.
go back to reference Schwab JS, Diangelo DJ, Foley KT (2006) Motion compensation associated with single-level cervical fusion: where does the lost motion go? Spine Phila Pa (1976) 31(21):2439–2448CrossRef Schwab JS, Diangelo DJ, Foley KT (2006) Motion compensation associated with single-level cervical fusion: where does the lost motion go? Spine Phila Pa (1976) 31(21):2439–2448CrossRef
Metadata
Title
The application of zero-profile anchored spacer in anterior cervical discectomy and fusion
Authors
Zhiwen Wang
Weimin Jiang
Xuefeng Li
Heng Wang
Jinhui Shi
Jie Chen
Bin Meng
Huilin Yang
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 1/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3628-9

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