J Korean Neurosurg Soc.  2014 Aug;56(2):103-107. 10.3340/jkns.2014.56.2.103.

Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

• Son DK
• Son DW
• Kim HS
• Sung SK
• Lee SW
• Song GS

• KMID: 1956511
• DOI: http://doi.org/10.3340/jkns.2014.56.2.103

Abstract

OBJECTIVE
This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices.
METHODS
We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively.
RESULTS
The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group.
CONCLUSIONS
Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

Keyword

Zero-profile; Prevertebral soft tissue swelling; Anterior cervical discectomy and fusion; ACDF; Dysphagia

MeSH Terms

Asian Continental Ancestry Group
Deglutition Disorders*
Diskectomy*
Humans
Incidence
Intervertebral Disc
Retrospective Studies

Figure

• 

  Fig. 1 A : Schematic images of the Zero-P showing that interbody fusion is reinforced within two cranial and caudal locking screws and polyetheretherketone (PEEK) cage. B : The Zero-P spacer is visualized in plain films of antero-posterior and lateral view after successful operation.

• 

  Fig. 2 Prevertebral soft tissue thickness was calculated as mean value of the distance between the anterior surface of each vertebral body (Zero-P) or plate (CCP) and the air shadow of the airway. A : CCP group. B : Zero-P group. *Thickness=(A+B)/2.

• 

  Fig. 3 Plain films demonstrated the loosening and nonunion of screws to the vertebral body. A : On the day of the operation. B : One-month post-operatively.

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