| BMC Musculoskeletal Disorders | |
| Zero-profile implant (Zero-p) versus plate cage benezech implant (PCB) in the treatment of single-level cervical spondylotic myelopathy | |
| Mao Li1  Minfeng Gan1  Kangwu Chen1  Genlin Wang1  MinJie Shen1  HuiLin Yang1  RuoFu Zhu1  ZhiDong Wang1  | |
| [1] Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China | |
| 关键词: Cervical spondylotic myelopathy; Internal fixation; Efficacy; Spinal fusion; Intervertebral fusion device; | |
| Others : 1232861 DOI : 10.1186/s12891-015-0746-4 |
|
| received in 2015-03-13, accepted in 2015-10-02, 发布年份 2015 | |
PDF
|
|
【 摘 要 】
Background
Anterior cervical discectomy and fusion is the golden standard for anterior surgery treating elderly cervical degenerative disease, but the previous implant has some problems such as looseness, translocation, sinking and dysphagia, So Zero-p implant and PCB implant have been developed to decrease the complications.
Methods
The clinical data of 57 patients with single level cervical spondylotic myelopathy were retrospectively analyzed. 27 patients adopting Zero-p interbody fusion cage as implant (Zero-p group) and 30 patients adopting integrated plate cage benezech (PCB) as implant (PCB group) from January 2010 to October 2012. Observe whether are differences between the two groups of patients on operation time, intraoperatve blood loss,Japanese Orthopaedic Association (JOA) scores before and after operation, intervertebral height, cervical physiological curvature, fusion rate, Postoperative dysphagia rate and complications.
Results
Zero-p group’s operation time is 98.2 + 15.2 min and its intraoperatve blood loss is 88.2 + 12.9 ml, both of which are lower than those of PCB group (109.8 + 16.9 min,95.2 + 11.6 ml ), so their differences are statistically significant (P < 0.05). The two groups’ JOA scores 3 months after operation and in the last follow-up are significantly higher than those before operation, so the differences are statistically significant (P < 0.05). Coob angle 3 months after operation and in the last follow-up improves obviously compared with before operation, so the difference is statistically significant (P < 0.05). The two groups’ operation segments intervertebral height 3 months after operation and in the last follow-up improves obviously compared with before operation, so the difference is statistically significant (P < 0.05) Zero-p group has one patient with dysphagia after operation and PCB group has four patients with dysphagia after operation, so there is no statistical differences between the two groups on dysphagia rate (P > 0.05, P = 0.415). PCB group has two patients with screws backing out and two patients with hoarseness after operation, the two groups’ operation segments all saw bony union in the last follow-up. Zero-p group postoperative complications are lower than PCB group (P < 0.05, P = 0.044).
Conclusions
Zero-profile implant and PCB implant both achieved good clinical effects on the treatment of cervical spondylotic myelopathy, the two groups both saw bony union in operation segments, but Zero-profile implant has the advantages of easy operation, short operation time, less intraoperatve blood loss and less complications.
【 授权许可】
2015 Wang et al.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20151116080153381.pdf | 832KB | ||
| Fig. 3. | 33KB | Image | |
| Figure 2. | 162KB | Image | |
| Fig. 1. | 35KB | Image |
【 图 表 】
Fig. 1.
Figure 2.
Fig. 3.
【 参考文献 】
- [1]Kim SW, Limson MA, Kim SB, Arbatin JJ, Chang KY, Park MS, Shin JH, Ju YS. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J. 2009; 18(2):218-231.
- [2]Samartzis D, Shen FH, Goldberg EJ, An HS. Is autograft the gold standard in achieving radiographic fusion in one-level anterior cervical discectomy and fusion with rigid anterior plate fixation? Spine. 2005; 30(15):1756-1761.
- [3]Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, Vaccaro AR, Albert TJ. Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine. 2003; 28(2):134-139.
- [4]Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Lee GP, Robinson JS. Anterior cervical discectomy and fusion associated complications. Spine. 2007; 32(21):2310-2317.
- [5]Kasimatis GB, Panagiotopoulos E, Gliatis J, Tyllianakis M, Zouboulis P, Lambiris E. Complications of anterior surgery in cervical spine trauma: an overview. Clin Neurol Neurosurg. 2009; 111(1):18-27.
- [6]Park JB, Cho YS, Riew KD. Development of adjacent-level ossification in patients with an anterior cervical plate. J Bone Joint Surg Am. 2005; 87(3):558-563.
- [7]Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine. 2002; 27(22):2453-2458.
- [8]Tortolani PJ, Cunningham BW, Vigna F, Hu N, Zorn CM, McAfee PC. A comparison of retraction pressure during anterior cervical plate surgery and cervical disc replacement: a cadaveric study. J Spinal Disord Tech. 2006; 19(5):312-317.
- [9]Samandouras G, Shafafy M, Hamlyn PJ. A new anterior cervical instrumentation system combining an intradiscal cage with an integrated plate: an early technical report. Spine. 2001; 26(10):1188-1192.
- [10]Wang ZD, Zhu RF, Yang HL, Gan MF, Zhang SK, Shen MJ, Chen C, Yuan Q. The application of a zero-profile implant in anterior cervical discectomy and fusion. J Clin Neurosci. 2014; 21(3):462-466.
- [11]Gu Y, Yang HL, Chen L, Dong RB, Han GS, Wu GZ, Chen KW, Tang TS. Use of an integrated anterior cervical plate and cage device (PCB) in cervical anterior fusion. J Clin Neurosci. 2009; 16(11):1443-1448.
- [12]Vanek P, Bradac O, Delacy P, Lacman J, Benes V. Anterior interbody fusion of the cervical spine with Zero-P spacer: prospective comparative study-clinical and radiological results at a minimum 2 years after surgery. Spine. 2013; 38(13):E792-797.
- [13]Liu T, Yang HL, Xu YZ, Qi RF, Guan HQ. ACDF with the PCB cage-plate system versus laminoplasty for multilevel cervical spondylotic myelopathy. J Spinal Disord Tech. 2011; 24(4):213-220.
- [14]Wang JC, McDonough PW, Kanim LE, Endow KK, Delamarter RB. Increased fusion rates with cervical plating for three-level anterior cervical discectomy and fusion. Spine. 2001; 26(6):643-646.
- [15]Sevastikoglou JA, Bergquist E. Evaluation of the reliability of radiological methods for registration of scoliosis. Acta Orthop Scand. 1969; 40(5):608-613.
- [16]Pitzen TR, Chrobok J, Stulik J, Ruffing S, Drumm J, Sova L, Kucera R, Vyskocil T, Steudel WI. Implant complications, fusion, loss of lordosis, and outcome after anterior cervical plating with dynamic or rigid plates: two-year results of a multi-centric, randomized, controlled study. Spine. 2009; 34(7):641-646.
- [17]Vaccaro AR, Carrino JA, Venger BH, Albert T, Kelleher PM, Hilibrand A, Singh K. Use of a bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disc disruption. J Neurosurg. 2002; 97(4 Suppl):473-480.
- [18]Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg. 1958; 15(6):602-617.
- [19]Scholz M, Schnake KJ, Pingel A, Hoffmann R, Kandziora F. A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res. 2011; 469(3):666-673.
- [20]Lee MJ, Bazaz R, Furey CG, Yoo J. Influence of anterior cervical plate design on Dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech. 2005; 18(5):406-409.
- [21]Koller H, Hempfing A, Ferraris L, Maier O, Hitzl W, Metz-Stavenhagen P. 4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results. Eur Spine J. 2007; 16(12):2055-2071.
- [22]Riley LH, Vaccaro AR, Dettori JR, Hashimoto R. Postoperative dysphagia in anterior cervical spine surgery. Spine. 2010; 35(9 Suppl):S76-85.
- [23]Leonard R, Belafsky P. Dysphagia following cervical spine surgery with anterior instrumentation: evidence from fluoroscopic swallow studies. Spine. 2011; 36(25):2217-2223.
- [24]Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine. 2000; 25(22):2906-2912.
PDF