Evaluation of the Outcome of Zero-profile Implant in the Treatment of Single-level Cervical Spondylotic Myelopathy in the Indian Scenario - A Prospective Study

在印度人群中,零剖面种植体治疗单节段颈椎病脊髓型患者疗效的评估——一项前瞻性研究

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Abstract

INTRODUCTION: Anterior cervical discectomy and fusion for single-level degenerative disc prolapse with myelopathy has been traditionally instrumented with an anterior cervical plate with a cage. However, as it has been associated with multiple complications, Zero-profile implants with locking screws have recently been used. The purpose of this study was to analyse the clinical and radiological outcome of Zero-profile devices in treating single-level cervical spondylotic myelopathy in the Indian scenario. MATERIALS AND METHODS: In this prospective study, 30 patients have been treated by using two types of zero-profile implant: polyetheretherketone (PEEK) and Titanium. Apart from the per-operative parameters, both radiological and functional parameters (Japanese Orthopedic Association [JOA] and Neck Disability Index [NDI]) have been assessed at regular intervals up to a mean follow-up of 1 year. Complications related to the procedures have been documented and taken care of. RESULTS: Mean operative time was 65 ± 18 min, mean blood loss 60 ± 12 mL. The Cobb angle was significantly improved. Fusion with both types of implant was noted in around 75% cases at the end of 1 year. Subsidence was noted with PEEK implant in 25% cases. Disturbance of pre-vertebral soft tissue was minimum, which was reflected as only 26% cases of mild dysphagia at the end of 2 weeks. Both JOA score and NDI score improved significantly at the end of 1 year. No major complications were encountered. CONCLUSION: Zero-profile implants prove to be effective in the treatment of single-level cervical myelopathy due to their biomechanical stability, ability to restore radiological parameters, and capacity to provide long-term functional improvement.Level of Evidence: III.

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