New Implant Anchored Cage for Anterior Cervical Interbody Fusion

Abstract

Introduction Currently, the anterior cervical discectomy and fusion (ACDF) is the “gold standard” treatment after anterior cervical decompression, in elderly patients or those who have contraindications for disc prosthesis. In this context, a new anchored implant with zero profile has been introduced for ACDF, which seeks to solve the problems that entail to add an anterior cervical plate and to obtain a higher level of stability to the segment, in comparison with cage only. The objective of this study is to describe the operative and postsurgical results, associated to the new zero-profile implant COALITION (Globus Medical, Inc, Audubon, Pennsylvania, United States), in patients who had surgery after cervical spine degenerative disease. Materials and Methods The data of 32 patients were reviewed by the Spine surgeons of Hospital del Trabajador (Santiago de Chile), between 2011 and 2014 under the ACDF technique using COALITION, in the context of cervical degenerative disease. The operative time, ambulation start, hospital stay, and dysphagia and dysphonia were measured. Results The patients had an average age of 51.64 ± 9.78 DE, on a male/female ratio of 16/15. A total of 53 levels were obtained (C3–C4: 3, C4–C5: 12, C5–C6: 20, and C6–C7: 18). The operative time was an average of 167.64 ± 50.28 minutes, using autologous iliac crest graft. The ambulation start time was 1 day (range, 1–2 days), with a hospital stay of 4 days (range, 2–7 days). The immediate dysphagia in postoperative was 56.25%, from this 77.77% was mild according to Bazaz score. Only 22.2% of the patients with immediate dysphagia persisted with a mild level, according to Bazaz score after 1 week of discharge from hospital. None of the patients presented chronicle dysphagia. Only four patients presented dysphonia symptoms that remitted spontaneously. Conclusion The new zero-profile implant demonstrated good postoperative results, with a low dysphagia and dysphonia prevalence, and these were completely resolved in all the cases.