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Abstract：
BACKGROUND: The zero-profile implant system (Zero-P) and conventional plates have been widely used in anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis. The purpose of this study was to compare the effects of the application of Zero-P and new conventional plates (ZEVO, Skyline) in ACDF on the sagittal imaging parameters of cervical spondylosis patients and to analyze their clinical efficacy.
METHODS: We conducted a retrospective study on 119 cervical spondylosis patients from January 2018 to December 2021, comparing outcomes between those receiving the Zero-P device (n = 63) and those receiving a novel conventional plate (n = 56, including 46 ZEVO and 10 Skyline plates) through ACDF. Cervical sagittal alignment was assessed pre- and postoperatively via lateral radiographs. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were recorded at baseline, after surgery, and at the 2-year follow-up to evaluate patient recovery and intervention success.
RESULTS: There were significant differences in the postoperative C0-C2 Cobb angle and postoperative sagittal segmental angle (SSA) between patients in the novel conventional plate group and those in the Zero-P group (P < 0.05). Postoperatively, there were significant changes in the C2‒C7 Cobb angle, C0‒C2 Cobb angle, SSA, and average surgical disc height (ASDH) compared to the preoperative values in both patient groups (P < 0.05). Dysphagia in the immediate postoperative period was lower in the Zero-P group than in the new conventional plate group (0% in the Zero-P group, 7.14% in the novel conventional plate group, P = 0.046), and the symptoms disappeared within 2 years in both groups. There was no statistically significant difference between the two groups in terms of complications of adjacent spondylolisthesis (ASD) at 2 years postoperatively (3.17% in the Zero-P group, 8.93% in the novel conventional plate group; P = 0.252). According to the subgroup analysis, there were significant differences in the postoperative C2‒C7 Cobb angle, C0‒C2 Cobb angle, T1 slope, and ASDH between the ZEVO group and the Skyline group (P < 0.05). Compared with the preoperative scores, the JOA, NDI, and VAS scores of all groups significantly improved at the 2-year follow-up (P < 0.01). According to the subgroup analysis, the immediate postoperative NDI and VAS scores of the ZEVO group were significantly better than those of the Skyline group (P < 0.05).
CONCLUSIONS: In ACDF, both novel conventional plates and Zero-P can improve sagittal parameters and related scale scores. Compared to the Zero-P plate, the novel conventional plate has a greater advantage in correcting the curvature of the surgical segment, but the Zero-P plate is less likely to produce postoperative dysphagia.
METHODS: We conducted a retrospective study on 119 cervical spondylosis patients from January 2018 to December 2021, comparing outcomes between those receiving the Zero-P device (n = 63) and those receiving a novel conventional plate (n = 56, including 46 ZEVO and 10 Skyline plates) through ACDF. Cervical sagittal alignment was assessed pre- and postoperatively via lateral radiographs. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were recorded at baseline, after surgery, and at the 2-year follow-up to evaluate patient recovery and intervention success.
RESULTS: There were significant differences in the postoperative C0-C2 Cobb angle and postoperative sagittal segmental angle (SSA) between patients in the novel conventional plate group and those in the Zero-P group (P < 0.05). Postoperatively, there were significant changes in the C2‒C7 Cobb angle, C0‒C2 Cobb angle, SSA, and average surgical disc height (ASDH) compared to the preoperative values in both patient groups (P < 0.05). Dysphagia in the immediate postoperative period was lower in the Zero-P group than in the new conventional plate group (0% in the Zero-P group, 7.14% in the novel conventional plate group, P = 0.046), and the symptoms disappeared within 2 years in both groups. There was no statistically significant difference between the two groups in terms of complications of adjacent spondylolisthesis (ASD) at 2 years postoperatively (3.17% in the Zero-P group, 8.93% in the novel conventional plate group; P = 0.252). According to the subgroup analysis, there were significant differences in the postoperative C2‒C7 Cobb angle, C0‒C2 Cobb angle, T1 slope, and ASDH between the ZEVO group and the Skyline group (P < 0.05). Compared with the preoperative scores, the JOA, NDI, and VAS scores of all groups significantly improved at the 2-year follow-up (P < 0.01). According to the subgroup analysis, the immediate postoperative NDI and VAS scores of the ZEVO group were significantly better than those of the Skyline group (P < 0.05).
CONCLUSIONS: In ACDF, both novel conventional plates and Zero-P can improve sagittal parameters and related scale scores. Compared to the Zero-P plate, the novel conventional plate has a greater advantage in correcting the curvature of the surgical segment, but the Zero-P plate is less likely to produce postoperative dysphagia.
摘要：
背景：零轮廓植入系统（Zero-P）和常规钢板已广泛用于颈椎前路椎间盘切除术和融合术（ACDF）以治疗颈椎病。本研究的目的是比较应用Zero-P和新的常规板(ZEVO，Skyline)在ACDF上对颈椎病患者矢状面成像参数进行分析并分析其临床疗效。
方法：我们对2018年1月至2021年12月的119例颈椎病患者进行了回顾性研究，比较了接受Zero-P装置的患者（n=63）和通过ACDF接受新型常规钢板的患者（n=56，包括46ZEVO和10Skyline钢板）的结果。术前和术后通过侧位X线片评估宫颈矢状位。日本骨科协会（JOA），颈部残疾指数(NDI)在基线时记录视觉模拟量表(VAS)评分，手术后,并在2年的随访中评估患者的恢复和干预成功率。
结果：新型常规钢板组与Zero-P组患者术后C0-C2Cobb角和术后矢状节段角（SSA）差异有统计学意义（P<0.05）。术后,C2-C7Cobb角有显著变化,C0-C2Cobb角,SSA,两组患者的平均手术椎间盘高度（ASDH）与术前值相比（P<0.05）。术后即刻的吞咽困难在Zero-P组低于新的常规钢板组（Zero-P组的0％，新型常规钢板组为7.14%，P=0.046),两组症状均在2年内消失。两组术后2年相邻腰椎滑脱（ASD）的并发症无统计学差异（Zero-P组为3.17％，新型常规钢板组为8.93%；P=0.252）。根据亚组分析,术后C2~C7Cobb角有显著差异，C0-C2Cobb角,T1斜率,ZEVO组和Skyline组之间的ASDH（P<0.05）。与术前评分相比，JOA,NDI,随访2年,各组VAS评分均显著改善(P<0.01)。根据亚组分析,ZEVO组术后即刻NDI和VAS评分明显优于Skyline组(P<0.05)。
结论：在ACDF中，新型常规钢板和Zero-P均可改善矢状参数和相关量表评分。与零P板相比，新颖的常规钢板在矫正手术节段的曲率方面具有更大的优势，但是Zero-P板不太可能产生术后吞咽困难。
方法：我们对2018年1月至2021年12月的119例颈椎病患者进行了回顾性研究，比较了接受Zero-P装置的患者（n=63）和通过ACDF接受新型常规钢板的患者（n=56，包括46ZEVO和10Skyline钢板）的结果。术前和术后通过侧位X线片评估宫颈矢状位。日本骨科协会（JOA），颈部残疾指数(NDI)在基线时记录视觉模拟量表(VAS)评分，手术后,并在2年的随访中评估患者的恢复和干预成功率。
结果：新型常规钢板组与Zero-P组患者术后C0-C2Cobb角和术后矢状节段角（SSA）差异有统计学意义（P<0.05）。术后,C2-C7Cobb角有显著变化,C0-C2Cobb角,SSA,两组患者的平均手术椎间盘高度（ASDH）与术前值相比（P<0.05）。术后即刻的吞咽困难在Zero-P组低于新的常规钢板组（Zero-P组的0％，新型常规钢板组为7.14%，P=0.046),两组症状均在2年内消失。两组术后2年相邻腰椎滑脱（ASD）的并发症无统计学差异（Zero-P组为3.17％，新型常规钢板组为8.93%；P=0.252）。根据亚组分析,术后C2~C7Cobb角有显著差异，C0-C2Cobb角,T1斜率,ZEVO组和Skyline组之间的ASDH（P<0.05）。与术前评分相比，JOA,NDI,随访2年,各组VAS评分均显著改善(P<0.01)。根据亚组分析,ZEVO组术后即刻NDI和VAS评分明显优于Skyline组(P<0.05)。
结论：在ACDF中，新型常规钢板和Zero-P均可改善矢状参数和相关量表评分。与零P板相比，新颖的常规钢板在矫正手术节段的曲率方面具有更大的优势，但是Zero-P板不太可能产生术后吞咽困难。
