Adjacent segment motion following multi-level ACDF: a kinematic and clinical study in patients with zero-profile anchored spacer or plate

Cui, Wei; Wu, Bingxuan; Liu, Baoge; Li, Dongmei; Wang, Lei; Serrera-Figallo, María-Ángeles

doi:10.1007/s00586-019-06109-8

Cited by 16 publications

(7 citation statements)

References 35 publications

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“…It is difficult to operate under naked eye because of insufficient illumination, incomplete decompression and high risk of dural sac injury. What is more, the fusion segment 2 is likely to reduce the range of movement of cervical spine and decreased from 50.79° ± 12.88° to 30.76° ± 8.85° at postoperative 1 year after ACDF with zero‐profile anchored spacer. Although the ACDR was a feasible method for the treatment of degenerative cervical spondylosis, studies 5 showed that restrictions of the range of motion were present in eight cases (10.4%, 8/77) because of heterotopic ossifications, seven cases (9.1%, 7/77) had a spontaneous fusion of the treated segment 1 year postoperatively.…”

Section: Introductionmentioning

confidence: 99%

“…The anterior cervical approach has become the main method for the treatment of single‐segment and double‐segment lesions of the cervical spine. The main anterior surgical methods are anterior cervical discectomy and fusion (ACDF) 2 , anterior cervical corpectomy and fusion (ACCF) 3 and artificial cervical disc replacement (ACDR) 4 . Previous studies have shown that the symptoms of nerve compression in patients with single segment ACDF can be effectively alleviated.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Efficacy of Posterior Percutaneous Endoscopic Unilateral Laminotomy with Bilateral Decompression for Symptomatic Cervical Spondylotic Myelopathy

Zhao

et al. 2022

Orthopaedic Surgery

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Objective To compare the clinical efficacy of posterior percutaneous endoscopic unilateral laminotomy (PPEUL) and anterior cervical decompression and fusion (ACDF) in the treatment of single‐segment spondylotic myelopathy (CSM). Methods This is a retrospective research, from January 2017 to December 2019, 30 cases were included in the PPEUL group and 32 cases were included in the ACDF group. The operative duration, blood loss, length of stay, complications, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) score, MacNab classification and imaging data were collected preoperatively, postoperative 1‐week, final follow‐up and statistically analyzed. Results The surgery was completed successfully on all patients, and there were no serious complications, such as nerve or spinal cord injury or infection. In the PPEUL and ACDF groups, the operative duration were 56.63 ± 1.40 and 65.21 ± 2.45 min, the intraoperative blood loss were 51.69 ± 3.23 and 50.51 ± 5.48 mL, and the hospitalization duration was 5.75 ± 1.43 and 6.38 ± 2.16 days. The follow‐up period in the PPEUL and ACDF groups was 24.96 ± 1.12 months and 25.65 ± 1.45 months, respectively. There was no significant difference in intraoperative blood loss between the two groups, but the hospitalization and operative durations in the PPEUL group were significantly shorter than those in the ACDF group (P < 0.05). The VAS scores at postoperative 1 week and final follow‐up were significantly improved compared with those before surgery. The JOA scores at postoperative 1 week and final follow‐up were significantly improved compared with those before surgery, but there was no significant difference between the two groups at the last follow‐up. The intervertebral disc height of the adjacent segment at the last follow‐up was significantly lower in the ACDF group than in the PPEUL group (P < 0.05), but there was no significant difference between the two groups in the intervertebral disc height of the surgical segment (P > 0.05). The rate of excellent and good results was 90.0% and 87.5%, respectively. Postoperative cervical CT and MRI showed that the spinal canal was fully decompressed and spinal cord compression was relieved. Conclusion PPEUL has the advantages of reduced trauma, rapid recovery and remarkable curative efficacy, so it is a new choice for the treatment of CSM.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy of Posterior Percutaneous Endoscopic Unilateral Laminotomy with Bilateral Decompression for Symptomatic Cervical Spondylotic Myelopathy

Zhao

et al. 2022

Orthopaedic Surgery

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“…Sun et al [13] suggested that different numbers of treated segments, bias of personal skill, and small number of cases might contribute to the controversy. However, few studies have synthesized these multifaceted factors [20]. A meta-analysis by Liu et al [21] focused on the subsidence, representing a loss of correction in disk height, in patients who had one-tofour levels of operation.…”

Section: Introductionmentioning

confidence: 99%

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

et al. 2022

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Background Anterior cervical diskectomy and fusion (ACDF) has been widely accepted as a gold standard for patients with cervical spondylotic myelopathy (CSM). However, there was insufficient evidence to compare the changes in the cervical alignment with different fusion devices in a long follow-up period. This meta-analysis was performed to compare the radiologic outcomes and loss of correction (LOC) in cervical alignment of Zero-profile (ZP) device versus cage-plate (CP) construct for the treatment of CSM. Methods Retrospective and prospective studies directly comparing the outcomes between the ZP device and CP construct in ACDF were included. Data extraction was conducted and study quality was assessed independently. A meta-analysis was carried out by using fixed effects and random effects models to calculate the odds ratio and mean difference in the ZP group and the CP group. Results Fourteen trials with a total of 1067 participants were identified. ZP group had a lower rate of postoperative dysphagia at the 2- or 3-month and 6-month follow-up than CP group, and ZP group was associated with a decreased ASD rate at the last follow-up when compared with the CP group. The pooled data of radiologic outcomes revealed that there was no significant difference in postoperative and last follow-up IDH. However, postoperative and last follow-up cervical Cobb angle was significantly smaller in the ZP group when compared with the CP group. In subgroup analyses, when the length of the last follow-up was less than 3 years, there was no difference between two groups. However, as the last follow-up time increased, cervical Cobb angle was significantly lower in the ZP group when compared with the CP group. Conclusion Based on the results of our analysis, the application of ZP device in ACDF had a lower rate of postoperative dysphagia and ASD than CP construct. Both devices were safe in anterior cervical surgeries, and they had similar efficacy in correcting radiologic outcomes. However, as the last follow-up time increased, ZP group showed greater changes cervical alignment. In order to clarify the specific significance of LOC, additional large clinical studies with longer follow-up period are required.

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“…Fusion surgery has been reported to be the gold-standard intervention after failure of conservative treatment in patients with symptomatic CDDD. [1][2][3] Anterior cervical discectomy and fusion (ACDF) has been shown to produce satisfactory clinical outcomes, as it may relieve the symptoms. [4][5][6] Since its initial description 50 years ago, this technique has undergone extensive modifications.…”

mentioning

confidence: 99%

“…Cervical disk degenerative disease (CDDD), which causes compression of the spinal cord that results in damage to neurological function, is one of the most significant causes of declining quality of life in middle-aged and aged people. Fusion surgery has been reported to be the gold-standard intervention after failure of conservative treatment in patients with symptomatic CDDD 1–3. Anterior cervical discectomy and fusion (ACDF) has been shown to produce satisfactory clinical outcomes, as it may relieve the symptoms 4–6.…”

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confidence: 99%

Does Early Postoperative T1 Slope Change Affect Clinical Results of Patients With Single-level ACDF?

Guo¹,

Líu²,

Meng³

et al. 2021

Clinical Spine Surgery: A Spine Publication

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Objective:The main question of this study is whether the change of postoperative T1 slope will affect the clinical and imaging recovery of patients with single-level anterior cervical discectomy and fusion (ACDF).Summary of Background Data: The T1 slope after ACDF is different from that preoperatively, however, the clinical significance of this change has not been reported. Materials and Methods:A retrospective analysis was conducted on 87 patients with single-level ACDF. Visual Analogue Scale was used to compare neck and upper limb pain before and after surgery. Neurological improvement was assessed by the Japanese Orthopaedic Association Scores and Neck Disability Index. Preoperative and postoperative T1 slope, occipital-C2 angle, C2-C7 overall curvature and functional spinal unit curvature were measured and analyzed by lateral cervical spine x-ray.Results: All patients were followed up for 23.98 ± 12.17 months. The Japanese Orthopaedic Association, Visual Analogue Scale, and Neck Disability Index scores as well as the overall curvature and change of C2-C7 and functional spinal unit were significantly improved in the last postoperative follow-up. At 12 months after surgery and the last follow-up, patients with increased T1 slope had more severe neck pain symptoms than those with decreased T1 slope (P < 0.05). The overall curvature and change of C2-C7 in patients with increased T1 slope were better than those with decreased T1 slope (P < 0.05). Conclusion:For patients with increased postoperative T1 slope after single-level ACDF, the degree of postoperative neck pain was more severe, suggesting that some clinical intervention is needed.

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Adjacent segment motion following multi-level ACDF: a kinematic and clinical study in patients with zero-profile anchored spacer or plate

Cited by 16 publications

References 35 publications

Clinical Efficacy of Posterior Percutaneous Endoscopic Unilateral Laminotomy with Bilateral Decompression for Symptomatic Cervical Spondylotic Myelopathy

Clinical Efficacy of Posterior Percutaneous Endoscopic Unilateral Laminotomy with Bilateral Decompression for Symptomatic Cervical Spondylotic Myelopathy

Changes in cervical alignment of Zero-profile device versus conventional cage-plate construct after anterior cervical discectomy and fusion: a meta-analysis

Does Early Postoperative T1 Slope Change Affect Clinical Results of Patients With Single-level ACDF?

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