The Comparison Studies Of Self-locking Zero-profile Intervertebral Fusion System And Conventional Plate-screw Construct For Treating Cervical Spinal Cord Injury Without Radiographic Abnormality

Objective To compare the clinical efficiency of self-locking zero-profile intervertebral fusion system(ROI-C)and conventional plate-screw construct for treating cervical spinal cord injury without radiographic abnormality.To evaluate the efficacy and security of ROI-C in the treatment of cervical spinal cord injury without radiographic abnormality.Methods Ninety-five patients who diagnosed as cervical spinal cord injury without radiographic abnormality were collected in this study ranged from July 2012 to August 2016.All patients were treated on anterior cervical discectomy and fusion.Among them,38 patients were applied with self-locking zero-profile ROI-C which defined as group A;and the rest 57 patients were applied with traditional plate-screw constructs which defined as group B.The duration of surgery,intraoperative blood loss,Japanese Orthopaedic Association(JOA)scores,intervertebral height,cervical Cobb angle,fusion rate and postoperative complications were elaborately compared between these two groups.Results There were significant statistical differences between the two groups concerning about the duration of surgery and intraoperative blood loss(P<0.05).Prominently improvement of JOA scores,intervertebral height and cervical Cobb angle were achieved in 1month after operation,3months after operation and the last follow-up time compared with preoperative data in both two groups(P<0.05).However,there was no significant difference of JOA scores,intervertebral height and cervical Cobb angle between two groups at the same follow-up time point(P>0.05).The intervertebral fusion rate were 88% and 90% in group A and group B respectively at the follow-up time of 3months after operation.At the final follow-up time,all patients of group A and group B got firm intervertebral fusion.There were no postoperative complications occurred during the follow-up time such as implant shifting or breakage,deterioration of neural function or faster adjacent segment degeneration.The incidence of postoperative dysphagia were respectively 13% and 32% of group A and group B at 1month after surgery;while the incidence turned into 0 and 14% of group A and group B respectively at 3months after surgery.At the final follow-up,postoperative dysphagia rate were 0 and 2% of group A and group B.Postoperative dysphagia in group A revealed much less compared with group B at 1month and 3months after surgery(P < 0.05),however,no statistical difference was found at the final follow-up(P > 0.05).Conclusions The application of self-locking zero-profile ROI-C in treating cervical spinal cord injury without radiographic abnormality is safe and effective,which not only can achieve similar clinical outcomes compared with traditional plate-screw construct,but also have superior advantages such as shorter operating time,less soft tissue injury and lower postoperative dysphagia occurrence rate.