Zero-profile anterior cervical interbody fusion for cervical spondylosis：short-period evaluation of support and fixation outcomes / 中国组织工程研究

ABSTRACT

BACKGROUND:The anterior cervical discectomy and fusion has a curative effect in treatment of cervical spondylosis, but has such complications as dysphagia and esophagostoma. A new anterior cervical interbody fusion, with support, fusion and fixation function, was researched successfuly and applied to clinical treatment in 2008. OBJECTIVE:To analyze the short-period clinical outcome of the zero-profile anterior cervical interbody fusion for cervical spondylosis. METHODS:A total of 20 patients (21 segments) undergoing anterior cervical discectomy and zero-profile anterior cervical interbody fusion were enroled in this study. Visual analogue scale and Japanese Orthopaedic Association were used to evaluate the improvement of ache and neurological function. The excelent and good rate of Japanese Orthopaedic Association was calculated in the final folow-up. Bazaz standards were utilized to assess the symptom of dysphagia after operation. The incidence of dysphagia was recorded. Anteroposterior and lateral radiographs were compared before and after treatment. Short-period clinical outcomes were evaluated using the recovery of intervertebral height, fusion condition and fixation-associated complications. RESULTS AND CONCLUSION: The operation time was between 70 and 170 minutes (averagely 93.4 minutes), blood loss was between 20 and 260 mL (averagely 107.6 mL) and length of stay was between 4 to 9 days (averagely 5.3 days). Al patients were folowed up for 13 to 20 months. Visual analogue scale scores were significantly lower at 2 days and 1 month posttreatment and final folow-up compared with preoperation (P< 0.05-0.01). Japanese Orthopaedic Association scores were significantly higher at 2 days and 1 month posttreatment and final folow-up compared with preoperation (P < 0.01). The excelent and good rate of Japanese Orthopaedic Association was 95% (19/20) in final folow-up. Among two patients who had dysphagia within 1 week after operation, one was mild and the other was moderate. Symptomatic treatment was conducted. The symptom disappeared in one case within 2 weeks after treatment and in one case within 2 months after treatment. Anteroposterior and lateral radiographs revealed that the intervertebral height obtained a certain increase and achieved bone fusion 95% (19/20) at final folow-up. There were no complications such as fixator loosening, breakage and shifting. Results suggested that zero-profile anterior cervical interbody fusion for cervical spondylosis is simple to operate, has smal trauma on cervical tissues, can obviously lessen pain, improve neurological function, has good support fixation and fusion functions, and can effectively recover intervertebral height. Postoperative complications are rare. Short-period clinical results are satisfactory.