Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2016 Sep;23(3):146-153. Korean.
    Published online Sep 30, 2016.
    https://doi.org/10.4184/jkss.2016.23.3.146
    © Copyright 2016 Korean Society of Spine Surgery
    Original Article

    Anterior Cervical Fusion Using a Zero-Profile Stand-Alone Cage: Radiological and Clinical Outcomes after More than 2 Years of Follow-Up

    Han Chang, M.D. and Byung-Wan Choi, M.D.*
      • Department of Orthopedic Surgery, Busan Korea Hospital, Busan, Korea.
      • *Department of Orthopedic Surgery, Inje University, Haeundae Paik Hospital, Busan, Korea.
    • Corresponding author: Byung Wan Choi, M.D. Department of Orthopedic Surgery, Inje University, Haeundae Paik Hospital 1435, Jwa-dong, Haeundae-gu Busan 612-030, Korea. TEL: +82-51-797-0240, FAX: +82-51-797-0249, Email: alla1013@naver.com
    Received September 21, 2015; Revised October 07, 2015; Accepted April 26, 2016.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Study Design

    Retrospective analysis.

    Objectives

    To analyze the usefulness of Zero-P® by analyzing the radiological and clinical outcomes with a minimum of 2 years of follow-up.

    Summary of Literature Review

    Anterior discectomy and fusion (ACDF) using Zero-P® showed excellent results. However, there is a lack of studies focusing on long-term outcomes.

    Materials and Methods

    Ninety-eight patients who underwent single-level ACDF using Zero-P® with more than 2 years of follow-up were included for analysis. In the radiological analysis, we evaluated disc height, segmental lordosis, and subsidence in the preoperative, postoperative, and last follow-up periods. The Neck Disability Index (NDI), Neck Visual Analogue Scale (VAS), and Arm VAS were also evaluated for clinical assessment. Radiological bony fusion was assessed, and radiological and clinical differences according to bony fusion were evaluated.

    Results

    Intervertebral disc height had increased 2.92 mm after surgery and subsided to 2.36 mm at the final follow-up. Subsidence of the screw was 0.58 mm at final follow-up. Segmental lordosis was 3.97° at the preoperative assessment, 8.39° in the postoperative follow-up, and 5.83° in the last follow-up. The Neck VAS score was 4.47, 2.28, and 1.27, respectively. The Arm VAS score was 5.73, 3.13, and 2.18; and NDI score was 17.8, 11.7, and 7.89, respectively. There was no association between the radiological and clinical results. Radiological nonunion was found in 18 subjects. There were no significant differences in radiological and clinical parameters according to bony union.

    Conclusions

    ACDF with Zero-P® for treatment of degenerative cervical disease showed subsidence in 55.1% and nonunion in 18% of cases. However, the radiological results were not related to the clinical results.

    Keywords
    Cervical spine; Anterior fusion; Zero-P®; Subsidence; Nonunion

    Figures

    Fig. 1
    (A) Measurement of intervertebral distance (A) and Cobb angle (B), (B) Subsidence of the cage screw was measured by analyzing change in distance (d) between the tip of the screws A and posterior margin of the vertebral body.

    Tables

    Table 1
    Correlation between radiological finding and clinical outcomes

    Table 2
    Comparison of the demographic, radiololocal, and clinical outcomes according to subsidence

    Table 3
    Comparison of the demographic, radiololocal, and clinical outcomes according to bony union

    Table 4
    Summary of the studies on cage subsidence and union

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    MeSH Terms
    Animals
    Arm
    Diskectomy
    Follow-Up Studies*
    Humans
    Intervertebral Disc
    Lordosis
    Neck
    Retrospective Studies
    Metrics
    Share
    Figures
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    Tables
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