J Korean Soc Spine Surg.  2016 Sep;23(3):146-153. 10.4184/jkss.2016.23.3.146.

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

• Chang H
• Choi BW

• KMID: 2353904
• DOI: http://doi.org/10.4184/jkss.2016.23.3.146

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.

Keyword

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

MeSH Terms

Animals
Arm
Diskectomy
Follow-Up Studies*
Humans
Intervertebral Disc
Lordosis
Neck
Retrospective Studies

Figure

• 

  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 and posterior margin of the vertebral body.

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