J Korean Neurosurg Soc.  2015 Aug;58(2):119-124. 10.3340/jkns.2015.58.2.119.

Cervical Stand-Alone Polyetheretherketone Cage versus Zero-Profile Anchored Spacer in Single-Level Anterior Cervical Discectomy and Fusion : Minimum 2-Year Assessment of Radiographic and Clinical Outcome

• Cho HJ
• Hur JW
• Lee JB
• Han JS
• Cho TH
• Park JY

• KMID: 2191319
• DOI: http://doi.org/10.3340/jkns.2015.58.2.119

Abstract

OBJECTIVE
We compared the clinical and radiographic outcomes of stand-alone polyetheretherketone (PEEK) cage and Zero-Profile anchored spacer (Zero-P) for single level anterior cervical discectomy and fusion (ACDF).
METHODS
We retrospectively reviewed 121 patients who underwent single level ACDF within 2 years (Jan 2011-Jan 2013) in a single institute. Total 50 patients were included for the analysis who were evaluated more than 2-year follow-up. Twenty-nine patients were allocated to the cage group (m : f=19 : 10) and 21 for Zero-P group (m : f=12 : 9). Clinical (neck disability index, visual analogue scale arm and neck) and radiographic (Cobb angle-segmental and global cervical, disc height, vertebral height) assessments were followed at pre-operative, immediate post-operative, post-3, 6, 12, and 24 month periods.
RESULTS
Demographic features and the clinical outcome showed no difference between two groups. The change between final follow-up (24 months) and immediate post-op of Cobb-segmental angle (p=0.027), disc height (p=0.002), vertebral body height (p=0.033) showed statistically better outcome for the Zero-P group than the cage group, respectively.
CONCLUSION
The Zero-Profile anchored spacer has some advantage after cage for maintaining segmental lordosis and lowering subsidence rate after single level anterior cervical discectomy and fusion.

Keyword

Zero-profile; Anterior cervical discectomy and fusion; Stand-alone cage; Kyphosis; Subsidence

MeSH Terms

Animals
Arm
Body Height
Diskectomy*
Follow-Up Studies
Humans
Kyphosis
Lordosis
Retrospective Studies

Figure

• 

  Fig. 1 Simple X-ray lateral view of patient operated with Zero-P anchored spacer. Cobb-c indicates the angle (°) between the lower margin of C2 and C7 vertebral bodies, Cobb-s indicates the angle (°) between upper margin of cranial vertebral body and the lower margin of caudal vertebral body of operated level, VH indicates the length (mm) between the midline of upper margin of cranial vertebral body and the lower margin of caudal vertebral body of operated level, DH indicates the length (mm) between the midline of upper and lower margin of disc space at operated level, and AP indicates the length (mm) of upper margin at the cranial vertebral body for operated level. Zero-P : Zero-Profile, VH : vertebral height, DH : disc height, AP : anterior-posterior.

• 

  Fig. 2 Serial follow up graph for Cobb-s angle (°). The Cobb-s angle shows improvement after immediate post-op and declines as time pass for both group. Change after immediate post-op and post-op 24-month shows significant difference between two groups (*p=0.027), the Zero-P group has lesser decline. Zero-P : Zero-Profile.

• 

  Fig. 3 Serial follow up graph for aDH. The aDH shows immediate improval after surgery but aggravates as follow up. At final follow up, cage group showed significantly shorter aDH than Zero-P group (*p=0.001). Zero-P : Zero-Profile, aVH : actual length of vertebral height.

• 

  Fig. 4 Serial follow up graph for aVH. The aVH shows improvement after operation but declines as time. Though the statistic difference are not proved, the gap between two groups get larger as time pass. Zero-P : Zero-Profile, aVH : actual length of vertebral height.

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