Abstract
BackgroundAlthough ACDF has been widely used in treating cervical spondylosis and related diseases, the complications along with this anterior surgical technique have hindered its application and affected the postoperative outcome of the patients. Here, we investigated the clinical and radiological outcomes of a new integrated low-profile anterior plate and cage system for anterior cervical discectomy and fusion (ACDF) in treating cervical spondylosis.MethodsA total of 96 cervical spondylosis patients who underwent single-level ACDF between 2018 to 2020 in our institute were enrolled. There were 28 patients using the new implants and 68 patients using the zero-profile (Zero-P) implants. The Japanese Orthopedic Association (JOA) score and the visual analog scale (VAS) were used to evaluate the clinical outcomes. The cervical and segmental Cobb angle and range of motion (ROM) were used to assessed the radiological outcomes. Incidence of complications were also recorded. All data were recorded at pre-operation, 6-month and 12-month post-operation.ResultsAll patients were followed-up for at least 1-year, the mean follow-up time was over one year. The fusion rate was similar in the two groups. There was no significant difference in the postoperative JOA score recovery rate, postoperative VAS score of neck and arm pain, postoperative ROM, and incidence of complications between two groups (P > 0.05). However, postoperative cervical and segmental Cobb angle were better maintained in the new low-profile implant group compared to Zero-P group.ConclusionsThe clinical outcomes of the new low-profile implant were satisfactory and comparable to that of zero-profile system. It may have advantages in improving and maintaining the cervical lordosis, and can be an alternative device for single-level cervical spondylosis treated with ACDF.
Highlights
Anterior cervical discectomy and fusion (ACDF) has been widely used in treating cervical spondylosis and related diseases, the complications along with this anterior surgical technique have hindered its application and affected the postoperative outcome of the patients
The new integrated low-profile implant Carmen was first used in 2018 in our institute, and was used in 28 patients until January 2020. 68 patients who received singlelevel ACDF with zero-profile implant (Zero-P) device were defined as Zero-P group
The surgical segments ranged from C3 to C7, and the distribution of lesion segment showed no significant difference between two groups (P = 0.208)
Summary
ACDF has been widely used in treating cervical spondylosis and related diseases, the complications along with this anterior surgical technique have hindered its application and affected the postoperative outcome of the patients. We investigated the clinical and radiological outcomes of a new integrated low-profile anterior plate and cage system for anterior cervical discectomy and fusion (ACDF) in treating cervical spondylosis. Considering the drawbacks of both types of implants, we here present a new integrated low-profile anterior plate and cage system (Carmen, Shanghai Sanyou Medical Co., Ltd, Shanghai, China) which is approved by the United States Food and Drug Administration in 2018. In this system, a titanium triangular thin plate with 3 screw trajectories can be attached to polyetheretherketone (PEEK) made disc spacer (Fig. 1a–c), since it mimics the zero-profile system and retain small plate design for screw fixation, we name it a low-profile anterior plate and cage system. The purpose of this study is to give the initial outcome of this new system and compare the clinical and radiological outcomes with the zero-profile implant
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