| Background: Cervical spondylopathy is a common disease in spinal surgery.Anterior cervical discectomy and fusion(ACDF)is a classic surgical procedure for cervical spondylosis.It has achieved good clinical efficacy.However,the adjacent segment degeneration(ASD)that occurs after surgery is a common cause of postoperative revision of ACDF.Zero-profile(Zero-P)implant system and traditional titanium plate combined with Cage system are two different types of internal fixation of ACDF.In the aspect of adjacent segment degeneration,Whether there is any difference between Zero-P implant system and traditional titanium plate combined with Cage system requires to be further studied.Objective: To compare the efficacy of two different types of internal fixation using Zero-P implant system or titanium plate combine with Cage and the occurrence of postoperative degeneration of adjacent segments after single-segment ACDF by retrospective analysis.Methods: The clinical data of cases with single-segment cervical spondylosis who underwent ACDF by Zero-P implant system or traditional titanium plate with Cage from January 2016 to January 2018 in the Affiliated Hospital of Qingdao University were retrospectively analyzed.The gender,age,operation time and postoperative dysphagia were compared between the two groups;Postoperative imaging evaluation and compare used cervical spine X-ray to measures the cervical curvature,height of intervertebral space,and adjacent segment degeneration;The clinical efficacy was evaluated and compared based on the View Analog Scales(VAS),and the neurological function recovery was evaluated and compared by scales of Japanese Orthopaedic Association(JOA)scores.Results: A total of 46 patients were included in this study,including 20 cases in the Zero-P group and 26 cases in traditional titanium plate combined with Cage group.The male to female ratio is 9/11 and 15/11 respectively.All patients were followed up for 24 to 48 months,with an average of 33.67±7.08 months.The average follow-up time of the Zero-P group was 33.05±6.06 months,and the average follow-up time of the Cage group was 34.15±7.86 months.The average operation time of the Zero-P group was 71.40±4.76 minutes,which was significantly shorter than that of the Cage group,78.81±5.80 minutes.The difference was statistically significant(P <0.05).At the last follow-up,all patients in both groups were all osseointegrated,and the fusion rate was 100%.There are significant differences between the two groups in terms of postoperative dysphagia.No cases of dysphagia occurred in the Zero-P group after operation,while 5 cases of dysphagia appeared in the Cage group,and all recovered within 6 weeks after operation.The incidence of postoperative dysphagia in the Zero-P group(0%)was significantly lower than that in the Cage group(19.23%),and the difference between the two groups was statistically significant(P<0.05).In the There is 1 case(5%)suffered from ASD in Zero-P group,and the degeneration was located at C6/7;In the titanium plate combined with Cage group,4 cases(15.4%)suffered from ASD,of which 3 patients were C6/7(11.5%)and 1 case(3.9%)in C5./6,There was no statistically significant difference in the incidence of ASD between the two groups(P>0.05).The incidence of ectopic ossification in the Zero-P group was significantly lower than that in the traditional titanium plate Cage group(P<0.05).The incidence of heterotopic ossification in the Zero-P group was significantly lower than that in the traditional titanium plate Cage group(P<0.05).The cervical curvature and height of intervertebral space in the last follow-up of the two groups were significantly improved,the parameters showed a significant difference(P<0.05),however comparison between the two groups showed no significant(P>0.05).The VAS scores and JOA scores at the last follow-up of the two groups were significantly improved compared with those before the operation.The difference was statistically significant(P<0.05),but there was no statistical difference between the groups(P>0.05).Conclusion: Zero-P implant system and traditional titanium plate combined with Cage system have achieved satisfactory clinical efficacy in the treatment of single-segment cervical spondylosis,and the therapeutic effects are similar.Zero-P has obvious advantages over titanium plate combined with Cage in shortening the operation time and reducing postoperative dysphagia.Zero-P can significantly reduce the incidence of ALOD compared to traditional titanium plate Cage,but two internal fixation methods are improving the operation.There was no significant difference in posterior cervical spondylolisthesis parameters and the incidence of ASD. |
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