Park Daniel, Arveschoug Anthony, Wahlmeier Steve, Petersen-Fitts Graysen, Zakko Phil
Orthopaedic Surgery, Beaumont Health, Royal Oak, USA.
Cureus. 2023 Jun 27;15(6):e41048. doi: 10.7759/cureus.41048. eCollection 2023 Jun.
Background and objective Anterior cervical discectomy and fusion (ACDF) is a common surgery involving the cervical spine. The goals of ACDF include obtaining a solid fusion and minimizing complications such as dysphagia. The effect of plate thickness on fusion, dysphagia, and patient outcomes is not well established. In light of this, this study aimed to evaluate the effect of plate thickness on fusion rates, complications, and outcomes in ACDF. Methods A case-control study involving ACDF performed by a single surgeon was conducted with the aim of comparing two commercially available plating systems: the Medtronic plate (Atlantis Vision Elite, Medtronic, Memphis, TN) and Aegis plate (CastleLoc-P, Aegis, Englewood, CO). The patients treated with the Medtronic plate served as the control group (Std) as the plate is widely utilized, while those treated with the Aegis plate, which is touted as one of the thinnest plates on the market, constituted the case low-profile group (LP). Demographic variables, fusion status, and patient-reported outcome measures (PROM) were compared between the two systems. Results Baseline demographic data were not significantly different between groups. The LP plate group had a significantly lower rate of fusion per patient as well as per level at 12 months. PROM did not significantly differ at any time point between the groups. Dysphagia scores could be correlated with radiographic measures reported in the Prevertebral Soft Tissue Swelling - Index (PVSTS-I). Conclusion Based on our findings, the plate thickness was not associated with dysphagia rates; however, the use of a thinner plate correlated with a lower rate of radiographic fusion at 12 months. The PVSTS-I may be useful for identifying patients with abnormal and severely abnormal dysphagia scores.
背景与目的 颈椎前路椎间盘切除融合术（ACDF）是一种常见的颈椎手术。ACDF的目标包括实现牢固融合并将诸如吞咽困难等并发症降至最低。钢板厚度对融合、吞咽困难及患者预后的影响尚未明确。鉴于此，本研究旨在评估钢板厚度对ACDF融合率、并发症及预后的影响。方法 开展一项病例对照研究，由单一外科医生实施ACDF，旨在比较两种市售钢板系统：美敦力钢板（Atlantis Vision Elite，美敦力公司，田纳西州孟菲斯）和宙斯盾钢板（CastleLoc-P，宙斯盾公司，科罗拉多州恩格尔伍德）。接受美敦力钢板治疗的患者作为对照组（标准组），因为该钢板被广泛使用，而接受宙斯盾钢板治疗的患者构成病例薄型组（LP），宙斯盾钢板被誉为市场上最薄的钢板之一。比较了两组之间的人口统计学变量、融合状态及患者报告的结局指标（PROM）。结果 两组之间的基线人口统计学数据无显著差异。LP钢板组在12个月时每名患者以及每个节段的融合率均显著较低。两组在任何时间点的PROM均无显著差异。吞咽困难评分可能与椎前软组织肿胀指数（PVSTS-I）报告的影像学测量结果相关。结论 根据我们的研究结果，钢板厚度与吞咽困难发生率无关；然而，使用较薄的钢板与12个月时较低的影像学融合率相关。PVSTS-I可能有助于识别吞咽困难评分异常和严重异常的患者。
