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Comparison of Zero-profile Anchored Spacer Versus Plate-and-Cage after 1-Level ACDF with Complete Uncinate Process Resection: A 3-Year Assessment of Radiographic and Clinical Outcomes

Authors
Noh, SH  | Park, JY | Kuh, SU | Chin, DK | Kim, KS | Cho, YE | Kim, KH
Citation
Clinical spine surgery, 34(5). : 176-182, 2021
Journal Title
Clinical spine surgery
ISSN
2380-01862380-0194
Abstract
Study Design: This is a retrospective study. Objective: The purpose of this study is to compare the zero-profile anchored spacer device (Zero-p) and traditional plate-and-cage implant (plate-and-cage) in anterior cervical discectomy and fusion (ACDF) with complete uncinate process resection (UPR) to treat 1-level cervical degenerative disk disease. Summary of Background Data: We retrospectively surveyed the data from all patients who underwent single-level ACDF with complete UPR between 2009 and 2013. Patients and Methods: In total, 80 patients participated in 3 years of follow-up. Among them, Zero-p (38 patients) and plate-and-cage (42 patients) approaches were used in ACDF with complete UPR. Clinical outcomes and radiographic results were compared between 2 groups and they were followed for 39.1±2.2 months. Results: Duration of operation, intraoperative blood loss, and length of hospitalization were significantly lower in the Zero-p group than the plate-and-cage group (P<0.001). The clinical outcomes of visual analog scale, neck disability index, and the Odom criteria were improved after operation in both groups. The fusion rates, C2-C7 lordosis, T1 slope, C2-C7 sagittal vertical axis, sellar turcica-C7 sagittal vertical axis, and spinocranial angle after single-level ACDF were not significantly different between the 2 groups. Subsidence occurred in 5 cases (13%) in the Zero-p group and 10 cases (37%) in the plate-and-cage group (P<0.05). The horizontal length of the Zero-p implant was longer than that of allograft bone. Fusion occurred in 37 cases (95%) of the Zero-p group and 40 cases (94%) in the plate-and-cage group. Conclusions: The Zero-p and plate-and-cage are effective when single-level ACDF with complete UPR was performed. Both groups showed good clinical outcomes, but Zero-p has more benefits than plate-and-cage such as lower duration of operation, intraoperative blood loss, length of hospitalization, and rate of subsidence compared with plate-and-cage. Surgeons should be aware of these results so that postoperative complications such as subsidence can be avoided.
Keywords

DOI
10.1097/BSD.0000000000001129
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Ajou Authors
노, 성현
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