Abstract
ObjectivesTo investigate the effect of the difference in C2–7 angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.MethodsA retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2–7 angle (dC2–7A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed.ResultsIn total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC2–7A were significantly different between the two groups (P < 0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC2–7A (P > 0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC2–7A were significantly associated with the incidence of dysphagia (P < 0.05).ConclusionsThe postoperative C2–7 angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.
Highlights
Anterior cervical discectomy and fusion (ACDF) has become a widely accepted and practiced surgical intervention for the treatment of cervical spondylosis and discHuang et al BMC Musculoskeletal Disorders (2020) 21:649 pseudarthrosis, kyphotic deformity, and graft donor site morbidity [5,6,7]
The Zero-profile standalone device (Zero-P) Implant System has been confirmed to reduce the incidence of complications to a considerable degree, many patients suffer from dysphagia after surgery [8,9,10]
Few reports have described the effect of the difference between postoperative and preoperative C2–7 angle on postoperative dysphagia after ACDF with Zero-P
Summary
Anterior cervical discectomy and fusion (ACDF) has become a widely accepted and practiced surgical intervention for the treatment of cervical spondylosis and discHuang et al BMC Musculoskeletal Disorders (2020) 21:649 pseudarthrosis, kyphotic deformity, and graft donor site morbidity [5,6,7]. The Zero-P Implant System has been confirmed to reduce the incidence of complications to a considerable degree, many patients suffer from dysphagia after surgery [8,9,10]. We noticed that after the ACDF with Zero-P, the changes in lordosis in some patients were obvious, especially the C2–7 angle; these changes could cause changes in the anatomical relationship between the cervical spine and the anterior esophagus, which may cause dysphagia. Several retrospective studies have reported that the change in O-C2A plays an important role in the development of dysphagia after occipitocervical fusion [11, 12]. A retrospective study based on 392 patients showed that the change in C2–7 angle plays an important role in the development of dysphagia in both ACDF with anterior plate and posterior cervical laminoplasty [13]. Few reports have described the effect of the difference between postoperative and preoperative C2–7 angle (dC2–7A) on postoperative dysphagia after ACDF with Zero-P
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