ZERO-PROFILE ANCHORED SPACER SYSTEM IN THE TREATMENT OF CERVICAL DEGENERATIVE DISEASE WITH A FOLLOW-UP OF 1 YEAROUR EXPERIENCE .

Abstract

Objects: Anterior cervical plating decreases the risk of pseudarthrosis, increases rate of fusion following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-prole, stand-alone interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited. We are reporting our ndings in term of clinico-radiological outcomes following the use of such devices in the treatment of cervical spine degenerative diseases with a focus on the course of postoperative prevertebral soft-tissue thickness and the incidence of dysphagia. The authors conducted a prospective analysis of all Methods: patients who had undergone ACDF between December 2018 and December 2019. All patients received a Zero-P implant (DePuy Synthes Spine).The Neck Disability Index (NDI),Modied Japanese Orthopaedic Association Score(mJOA) and visual analog scale (VAS) scores for arm and neck pain were documented. Dysphagia was determined using the Bazaz criteria. Prevertebral soft-tissue thickness, spinal alignment, intervertebral disc height were assessed as well. The nal outcome was assessed with Odom's criteria. Total 30 patients Results: were studied prospectively, and data were collected and analyzed. 17 male and 13 female consecutive patients, with a mean age of 48.28 ± 8.17 years, underwent ACDF with Zero-Prole spacer (42 total operated levels) in the dened study period. There were signicant improvements in neck and arm VAS scores, the NDI and mJOA scores following surgery at last follow up. The neck VAS score improved from a mean 7.34 ±1.87 to 1.04 ± 0.09 (p<0.01) . The arm VAS score improved from 7.22±2.03 to1.03±0.10 at latest follow up. NDI score improved signicantly from preoperative 31.94±6.73 to 12.87±5.24 and mJOAscore improved from preoperative 9.53±1.98 to 15.6±1.26 at last follow up. Immediate postoperative dysphagia was experienced by 36.67% of all patients. Complete resolution of dysphagia was demonstrated at the latest follow-up. Prevertebral soft-tissue thickness at postoperative 48 hrs decreased across all levels from a mean of 15.87 ±0.69 to 11.81 ± 0.53 mm at last follow up. Cervical alignment and intervertebral disc height were also improved signicantly after surgery. Radiographic fusion was achieved in 100% of implants. No correlation was found between prevertebral soft-tissue thickness and Bazaz dysphagia score. Majority of the patients had excellent outcomes in odom's criteria. Conclusions: Zero-Prole device is a safe and effective alternative for the treatment of cervical degenerative diseases. Chronic dysphagia rates are comparable to or better than those for previously published case series.