Azab Waleed, Abdel-Razek Mamdouh, Ali Abeer, Abdelrahman Ahmed, Salaheldin Waleed, Nasim Khurram, Attia Hosam, Soliman Doaa
Ibn Sina Hospital, Department of Neurosurgery, Kuwait, Kuwait.
Turk Neurosurg. 2012;22(5):611-7. doi: 10.5137/1019-5149.JTN.5646-11.2.
Supplementing anterior cervical diskectomy and fusion (ACDF) with plates enhances stabilization, increases fusion and reduces failure rates. Zero-P implant for stand-alone anterior interbody fusion procedures of the cervical spine was recently developed to avoid complications associated with anterior cervical plates. We evaluate the outcome of its use in our patients undergoing ACDF.
84 patients were selected to undergo ACDF with Zero-P implant of whom 75 (52 male and 23 female) were followed up for 12 to 16 months (mean 14.2 months) with a total of 94 operated levels (54 single, 21 double level). Patients underwent pre- and postoperative clinical evaluation with full neurological examination, visual analogue scale (VAS), Neck Pain and Disability Scale (NPAD) and Bazaz-Yoo dysphagia index for postoperative dysphagia. Postoperative plain X-ray evaluation of fusion and implant-associated complications was done. REAULTS: All patients had significant reduction in arm and neck pain and NPAD maintained over 12 months, no implant-associated complications during follow-up, and radiological fusion by 3 months. None had dysphagia after 3 months postoperatively.
The Zero-P implant is a valid alternative to anterior cervical plating after ACDF with a very low incidence of postoperative dysphagia and no implant-related complications.
颈椎前路椎间盘切除融合术(ACDF)联合钢板可增强稳定性、提高融合率并降低失败率。最近研发出用于颈椎前路独立椎间融合手术的Zero-P植入物,以避免与颈椎前路钢板相关的并发症。我们评估了其在接受ACDF的患者中的使用效果。
选择84例患者接受使用Zero-P植入物的ACDF手术,其中75例(52例男性和23例女性)接受了12至16个月(平均14.2个月)的随访,共94个手术节段(54个单节段,21个双节段)。患者在术前和术后接受了全面的神经学检查、视觉模拟量表(VAS)、颈部疼痛和功能障碍量表(NPAD)以及用于评估术后吞咽困难的Bazaz-Yoo吞咽困难指数等临床评估。术后进行了融合情况的X线平片评估以及与植入物相关的并发症评估。结果:所有患者的手臂和颈部疼痛均显著减轻,NPAD在12个月内保持稳定,随访期间无植入物相关并发症,术后3个月实现影像学融合。术后3个月后无一例出现吞咽困难。
Zero-P植入物是ACDF术后颈椎前路钢板的有效替代物,术后吞咽困难发生率极低,且无植入物相关并发症。