Abstract
Background The efficacy of anterior fusion using zero-profile implant (Zero-P) in the surgical
treatment of degenerative cervical disease was investigated through radiographic and
clinical comparisons with existing treatments using autograft or allograft and anterior
plating.
Material and Methods A total of 130 patients who underwent anterior decompression and fusion for degenerative
cervical spine disease with a follow-up of at least 1 year were analyzed retrospectively.
The cases were divided into three groups: autograft and plate (38 cases, group A),
allograft and plate (44 cases, group B), and Zero-P (48 cases, group C). Maintenance
of lordosis, extent of subsidence, and fusion were evaluated radiologically and compared
among preoperative, postoperative, and final follow-up time points. In addition, changes
in Visual Analog Scale (VAS) and Neurologic Disability Index (NDI) scores and the
presence of complications were evaluated for clinical analysis.
Results Operation time was significantly less in group C (p = 0.007, 0.002). Maintenance of entire and segmental lordosis after surgery was better
in groups A and B compared with group C (p = 0.002, 0.001); however, the extent of loss of lordosis from the surgery to the
final follow-up did not show any significant differences. Regarding the extent of
subsidence, the increase of height between the vertebral bodies after the surgery
was 3.10, 2.89, and 2.68 mm in group A, group B, and group C, respectively (p = 0.14), and changed to − 1.27, − 2.41, and − 1.2 mm at the final follow-up (p = 0.012). VAS and NDI scores were improved from 7.2 to 3 and 34 to 12, respectively,
but there were no significant differences. Nonunion occurred in two cases in both
group B and group C. In terms of clinical complications, two cases of persistent donor
site pain were found in group A; one case of persistent dysphagia was found in both
group A and group B.
Conclusion Anterior cervical fusion using Zero-P has a shorter operation time and less subsidence
compared with conventional surgical techniques. Thus it can be considered a useful
technique for the surgical treatment of degenerative cervical disease.
Keywords cervical spine - ACDF - zero-profile implant
