J Korean Neurosurg Soc.  2018 Sep;61(5):574-581. 10.3340/jkns.2018.0090.

Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

• Kim TH
• Kim DH
• Kim KH
• Kwak YS
• Kwak SG
• Choi MK

• KMID: 2420065
• DOI: http://doi.org/10.3340/jkns.2018.0090

Abstract

OBJECTIVE
The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury.
METHODS
Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria.
RESULTS
The C2-7 Cobb and operative segmental angles increased by 3.45±7.61 and 2.94±4.59 in group A; and 2.46±7.31 and 2.88±5.49 in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria.
CONCLUSION
The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

Keyword

Cervical vertebrae; Spinal cord trauma; Allograft

MeSH Terms

Allografts
Asian Continental Ancestry Group
Cervical Vertebrae
Diskectomy*
Female
Humans
Orthopedics
Retrospective Studies*
Spinal Cord Injuries
Spondylosis

Figure

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  Fig. 1. Magnetic resonance imaging of the patients revealed the type of associated traumatic cervical injury : a) prevertebral hemorrhage; b) signal change of the cervical cord; and c) suspicious injury of the interspinous ligament.

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  Fig. 2. Measurement of the cervical sagittal alignment : a) operative segmental angle; b) Cobb’s angle.

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  Fig. 3. Computed tomography showed additional new bone formation with bony bridging across the disc space.

Reference

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