Abstract

BackgroundAnterior cervical discectomy and fusion is the golden standard for anterior surgery treating elderly cervical degenerative disease, but the previous implant has some problems such as looseness, translocation, sinking and dysphagia, So Zero-p implant and PCB implant have been developed to decrease the complications.MethodsThe clinical data of 57 patients with single level cervical spondylotic myelopathy were retrospectively analyzed. 27 patients adopting Zero-p interbody fusion cage as implant (Zero-p group) and 30 patients adopting integrated plate cage benezech (PCB) as implant (PCB group) from January 2010 to October 2012. Observe whether are differences between the two groups of patients on operation time, intraoperatve blood loss,Japanese Orthopaedic Association (JOA) scores before and after operation, intervertebral height, cervical physiological curvature, fusion rate, Postoperative dysphagia rate and complications.ResultsZero-p group’s operation time is 98.2 + 15.2 min and its intraoperatve blood loss is 88.2 + 12.9 ml, both of which are lower than those of PCB group (109.8 + 16.9 min,95.2 + 11.6 ml ), so their differences are statistically significant (P < 0.05). The two groups’ JOA scores 3 months after operation and in the last follow-up are significantly higher than those before operation, so the differences are statistically significant (P < 0.05). Coob angle 3 months after operation and in the last follow-up improves obviously compared with before operation, so the difference is statistically significant (P < 0.05). The two groups’ operation segments intervertebral height 3 months after operation and in the last follow-up improves obviously compared with before operation, so the difference is statistically significant (P < 0.05) Zero-p group has one patient with dysphagia after operation and PCB group has four patients with dysphagia after operation, so there is no statistical differences between the two groups on dysphagia rate (P > 0.05, P = 0.415). PCB group has two patients with screws backing out and two patients with hoarseness after operation, the two groups’ operation segments all saw bony union in the last follow-up. Zero-p group postoperative complications are lower than PCB group (P < 0.05, P = 0.044).ConclusionsZero-profile implant and PCB implant both achieved good clinical effects on the treatment of cervical spondylotic myelopathy, the two groups both saw bony union in operation segments, but Zero-profile implant has the advantages of easy operation, short operation time, less intraoperatve blood loss and less complications.

Highlights

  • Anterior cervical discectomy and fusion is the golden standard for anterior surgery treating elderly cervical degenerative disease [1]

  • Interbody fusion cage replaces autogenous iliac to become the main way of posterior lumber intervertebral fusion, but it has some problems such as looseness, translocation, sinking and a low fusion rate of fusion cage [2, 3] which can be solved by implanting titanium plate before cervical spine, dysphagia, screws backing out, the looseness of titanium plate and other complications after operation arise [4,5,6,7,8]

  • Though the use of titanium plate reduces the occurrence rate of complications compared with the single use of bone graft or interbody fusion cage, it leads to the occurrence of the looseness, pulling away and fracture of screws, dysphagia and other complications

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Summary

Introduction

Anterior cervical discectomy and fusion is the golden standard for anterior surgery treating elderly cervical degenerative disease, but the previous implant has some problems such as looseness, translocation, sinking and dysphagia, So Zero-p implant and PCB implant have been developed to decrease the complications. Anterior cervical discectomy and fusion is the golden standard for anterior surgery treating elderly cervical degenerative disease [1]. There are only a few clinical researches about Zero-p interbody fusion cage and integrated anterior cervical plate cage benezech implant (PCB) treating cervical spondylotic myelopathy abroad [10,11,12,13].

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