Use of stand-alone anchored intervertebral cage in the surgical treatment of patients with symptomatic cervical spondylosis

Abstract

Background: One of the most common surgical operations for treatment of cervical spondylosis is anterior cervical discectomy with fusion (ACDF). In order to achieve stable fusion after discectomy and avoid dysphagia the artificial stand-alone zero-profile cages with integrated screws were developed and introduced into clinical practice. Outcome and complications after ACDF with such cages were not adequately assessed yet. Methods: We analyzed 20 consecutive patients with cervical spondylosis treated in our institution with ACDF with stand-alone zero-profile cage Zero-P. Before and after surgery and then 6, 12 and 24 months after surgery we assessed the level of pain with VAS scale, severity of myelopathy with mJOA scale and dysphagia with four level scale. Treatment outcome was assessed after 2 years according to Odom's criteria. Results: No complications occurred during surgery or recovery after surgery. The VAS score after surgery and then after 6, 12 and 24 months was statistically significantly lower than before surgery (p<0.05). The mJOA scores were 6, 12 and 24 months after surgery statistically significantly higher than before surgery (p<0.05). Transient and mild dysphagia was present after surgery in 15% (3/20) of patients and 6, 12 or 24 months after surgery in none. Outcome after 2 years was excellent in 9 patients and good in 11 patients. Conclusions: Operative treatment of symptomatic cervical spondylosis with ACDF using stand-alone zero-profile cage with integrated screws is safe and efficient. Incidence of dysphagia after surgery is low and generally transient.