ZERO-PROFILE DEVICE IMPLANTATION IN ANTERIOR CERVICAL DISCECTOMY AND FUSION: A SINGLE INSTITUTE EXPERIENCE
Background: A surgical procedure, anterior cervical discectomy and fusion (ACDF), is used for neural decompression in degenerative cervical disk disease and cervical spondylosis. A new type of cervical interbody cage, the Zero-profile device (ZPD), has been developed which could reduce postoperative complications among patients.
Objectives: The study aimed to examine the effect of ZPD on clinical outcomes and cervical spine alignment of enrolled patients at 1-year follow-up in the management of ADCF.
Methods: This study retrospectively evaluated the clinical and radiographic outcomes using the Zero-profile device (ZPD) in the anterior cervical discectomy and fusion (ACDF). All patients who underwent ACDF at Vajira Hospital between May 2017 and June 2021 were included in this study. Radiographic images obtained from picture archiving and communication systems (PACS) were used to evaluate the device-level Cobb angle (DLCA), segmental Cobb angle (SCA), global Cobb angle (GCA), sagittal vertical axis (SVA), and intervertebral disk height. The Japanese Orthopaedic Association (JOA) scores and visual analog scale (VAS) were obtained from the patients’ medical records. The preoperative DLCA, SCA, GCA, SVA, and intervertebral disk height measurements were compared with the postoperative measurements at 1 year.
Results: A total of 31 patients (45 disks) who underwent ACDF with the ZPD were included in this study. A significant improvement was found in JOA, VAS, DLCA, SCA, GCA, SVA, and intervertebral disk height after ACDF with ZPD (p<0.001). Immediate postoperative dysphagia occurred in two patients (6.5%), which resolved after 3 months. No subsidence was reported at 1-year follow-up. Age, BMI as well as the preoperative cervical alignment did not affect outcomes in this study.
Conclusion: The use of the ZPD in ACDF improved clinical and radiographic outcomes in the correction of cervical spine alignment, and minimized postoperative complications of dysphagia. No device-related failure occurred, and favorable outcomes persisted at 1-year follow-up.
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