Acta Chir Orthop Traumatol Cech. 2011; 78(6):562-567 | DOI: 10.55095/achot2011/089
Anterior Interbody Fusion of the Cervical Spine with a Zero-P Spacer. Radiographic Results with a Minimum Follow-up of One Year in a Prospective StudyOriginal papers
- Neurochirurgická klinika, Ústřední vojenská nemocnice Praha
PURPOSE OF THE STUDY:
The aim of this study was to compare the efficacy of anterior cervical microdiscectomy and fusion carried out using a newly designed interbody spacer with that of a standard cage plate construct in patients with symptomatic cervical spine spodylosis. The comparison was based on radiographic results and fusion rates.
MATERIAL:
A total number of 113 consecutive patients were enrolled in this prospective study between October 2008 and July 2009. Mono- or bisegmental spondylosis was diagnosed in the patients in whom conservative treatment of cervicobrachial symptoms had had no effect. Patients with myelopathy were not included.
METHODS:
All patients underwent standard anterior microdiscectomy (at one or two levels). The novel anchored spacer Zero-P was used in 61 patients (group 1) and, in 52 patients, stabilisation was done using the interbody spacer Cornerstone and dynamic plate Premier (group 2). Lateral radiographic views of the cervical spine were obtained before surgery and at 6 weeks, and then at 3, 6 and 12 months after surgery. During follow-up, the cervical spine sagittal alignment (CobbC), segmental angle of the treated levels (CobbS), amount of segmental collapse and fusion rates were measured.
RESULTS:
There was no significant difference in CobbC between the two groups during follow-up (p < 0.051). A significant difference in the first two values of CobbS was found (p < 0.001), but next changes in CobbS were without any difference in either group. The mean degree of interspace collapse was without any significant difference between the groups. The fusion rate was significantly higher in group 1 than group 2 nine months after surgery (p = 0.032), but was the same in both groups at 12 months after surgery (p = 1.0).
CONCLUSIONS:
The anchored spacer Zero-P provides biomechanical stability for the cervical spine similar to the cage and dynamic plate construct. Efforts to improve the cervical stand-alone anterior fusion device and to eliminate disadvantages of plate systems should be studied in larger patient groups with longer follow-ups.
Keywords: cervical spine, interbody fusion, fusion rate, radiology, stand-alone implant, Zero-P
Published: December 1, 2011 Show citation
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References
- BANWART, J. C.., ASHER, M. A., HASSANEIN, R. S.:Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine, 20: 1055-1060, 1995.
Go to original source...
Go to PubMed...
- BARSA, P., SUCHOMEL, P. Factor affecting sagittal malalignment due to cage subsidence in standalone cage assisted anterior cervical fusion. Eur.Spine J.,16: 1395-1400, 2007.
- BOHLER, J., GAUDERNAK, T.: Anterior plate stabilization for fracture dislocations of Loir cervical spine. J. Trauma, 20: 203-205, 1980.
Go to original source...
Go to PubMed...
- BRODSKY, A. E., KHALIL, M. A., SASSARD, W. R.: Repair of symptomatic pseudoarthosis of anterior cervical Psion. Posterior versus anterior repair. Spine, 17: 1137-1143, 1992.
Go to original source...
Go to PubMed...
- BUCK, B.E., MALINEN, T. I., BROWN, M. D.:Bone transplantation and human immunodeficiency virus: an estimate of acquired immunodeficiency syndrome (AIDS). Clin. Orthop. Relat. Res., 240: 129-136, 1989.
Go to original source...
- FERNÁNDEZ-FAIREN, M., SALA, P., DUFOO, M. JR., BALLESTER, J., MURCIA, A., MERZTHAL, L.: Anterior cervical fusion with tantalum implant: a prospective randomized controlled study. Spine, 33: 465-472, 2008.
Go to original source...
Go to PubMed...
- FRASER, J. F., HARTL, R.: Anterior approaches to fusion of the cervical spine: a metaanalysis of fusion rates. J. Neurosurg. Spine, 6: 293-303, 2007.
Go to original source...
Go to PubMed...
- HACKER, R. J.: A randomised prospective study of an anterior cervical fusion device with minimum 2 years follow up results. J. Neurosurg. (Spine2), 93: 222-226, 2000.
Go to original source...
Go to PubMed...
- KANDZIORA, F., PFLUGMACHER, R., SCHAFER, J., BORN, C., DUDA, G., HAAS, M.P., MITTLMEIER, T.: Biomechanical comparison of cervical spine interbody fusion cages. Spine, 26: 1850-1857, 2001.
Go to original source...
Go to PubMed...
- KAO, F. C., NIU, C. C., CHEN, L. H.: Maintaince of interbody space in one- and two-level anterior cervical interbody fusion: comparison of the effectiveness of autograft, allograft and cage. Clin. Orthop. Relat. Res., 430: 108-116, 2005
Go to original source...
Go to PubMed...
- KOLSTAD, F., NYGAARD, O.P, ANDERSEN, H., LEIVSETH, G.: Anterior cervical arthrodesis a "stand alone" cylindrical titanium cage. Prospective analysis of radiographic parameters. Spine 35: 1545-1550, 2010.
Go to original source...
Go to PubMed...
- LOFGREN, H., ENQUIST M., HOFFMANN, P., SIGSTEDT, B., VAVRUCH, L.: Clinical and radiological evaluation of trabecular metal and Smith-Robinson technice in anterior cervical fusion for degenerative dinase: a prospective, randomized controlled study with 2-year follow up. Eur.Spine J., 19: 464-473, 2010.
Go to original source...
Go to PubMed...
- LOWERY, G. I., MCDONOUGH, R.F.:The significance of hardware failure in anterior cervical plate fixation. Patient with 2 to 7 yer follow up.Spine, 23: 181-186, 1998.
Go to original source...
Go to PubMed...
- MATGE, G.: Cervical cage fusion with 5 different implants: 250 cases. Acta Neurochirurg.,144: 539-549, 2002.
- MCAFEE, P. C., CAPUCCINO, A., Cunningham, B. W., Devine, J. G., Phillips, F. M., Regan, J. J., Albert, T. J., Ahrens, J. E.: Lower incidence of dysphagia with cervical arthroplasty compared with ACDF in a prospective randomized clinical trial. J. Spinal. Disord. Tech., 23: 1-7, 2010.
Go to original source...
Go to PubMed...
- PEOLSSON, A., VAVRUCH, L., HEDLUND, R.: Long-term randomised comparison between a carbon fibre cage and the Cloward procedure in the cervical spine. Eur. Spine J., 16: 173-178, 2007.
Go to original source...
Go to PubMed...
- PITZEN, T. R., CHROBOK, J., ŠTULIK, J., RUFFING, S., DRUMM, J., SOVA, L., KUČERA, R., VYSKOČIL, T., STEUDEL, W. I.: Implant complications, Psion, los sof lordosis and outcome after anterior cervical plating with dynamic or rigid plates. Spine, 34: 641-646, 2009.
Go to original source...
Go to PubMed...
- RILEY, L. H., SKOLASKY, M. A., ALBERT, T. A.: Dysphagia after anterior cervical decompression and fusion: Prevalence and risk factors from a longitudinal cohort study. Spine, 30: 2564-2569, 2005.
Go to original source...
Go to PubMed...
- SHIMAMOTO, N., CUNNINGHAM, B. W., DMITRIEV, A. E., MINAMI, A., MCAFEE, P. C.: Biomechnical evaluation of stand-alone interbody fusion cage in the cervical spine. Spine, 26 : 432-436, 2001.
Go to original source...
Go to PubMed...
- SCHOLZ, M., REYES, P.M., SCHLEICHER, P., SAWA, A. G. U., BAEK, S., KANDZIORA, F., MARCIANO, F. F., CRAWFORD, N. R.: A New stand-alone cervical anterior interbody fusion. Biomechanical comparison with established anterior cervical fixation device. Spine 34: 156-160, 2009.
Go to original source...
Go to PubMed...
- SMITH, G. W., ROBINSON, R. A.: The tratment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion. J. Bone Jt Surg., 40-A: 607-624, 1958.
Go to original source...
- SONG, K. J.,TEGHAVI, C. E., LEE, K. B, SONG, J. H.: The efficacy of plate construct augmentativ versus stand alone in anterior cervical Psion. Spine, 34: 2886-2892, 2009.
Go to original source...
Go to PubMed...
- SUCHOMEL P., BARSA P., BUCHVALD P., SVOBODNÍK A., VANÍČKOVÁ E.: Autologous versus allogenic bone grafts in instrumented anterior discectomy and fusion: a prospective study with respekt to bone union patern. Eur. Spine J., 13: 510-5, 2004.
Go to original source...
Go to PubMed...
- ŠTULÍK, J., KRYL, J., ŠEBESTA, P., VYSKOČIL, T., KRBEC, M., TRČ, T.: Mobilní náhrada krční meziobratlové ploténky ProDisc- C: prospektivní monocentrická dvouletá studie. Acta Chir. orthop. Traum. čech., 75: 253-261, 2008.
Go to original source...
- THOME, C., LEHETA, O., KRAUSS J.K., ZEVGARIDIS, D.: A prospective randomized comparison of rectangular titanium cage Psion and iliac crest autograft fusion in patints undergoing anterior cervical discectomy. J. Neurosurg. Spine, 4: 1-9, 2006.
Go to original source...
Go to PubMed...
- VAVRUCH, L., HEDLUND, R., JAVID, D., LESZNIEWSKI, W., SHALABI, A.: A prospective randomized comparison between the Cloward procedure and a carbon fiber cage in the cervical spine: a clinical and radiologic study. Spine, 27: 1694-1601, 2002.
Go to original source...
Go to PubMed...
- ZDEBLICK, T. A., DUCKER, T. B.: The use of freeze-dried allograft bone for anterior cervical fusions. Spine, 16: 726-29, 1991.
Go to original source...
Go to PubMed...