Development and Clinical Application of a New Open-Powered Nail Anterior Cervical Plate System.

Objective: To observe and evaluate the clinical curative effect of a new type of open-powered cervical spine system developed for anterior cervical surgery.

Methods: A retrospective analysis was performed in our hospital in 2015-2017 of 329 orthopaedic patients treated with cervical anterior decompression, cage or titanium mesh graft fusion, new open-powered nail plate or traditional cervical anterior screw plate. A total of 154 (control group) and 175 (observation group) cases were fixed with conventional cervical- and new open-powered nail plates, respectively. Postoperative follow-up was performed. Cervical stability, internal fixation position, and bone graft fusion were evaluated by imaging. Operative time, intraoperative blood loss, cervical Cobb angle, pain visual analogue scale (VAS) score, and Japanese orthopaedic association (JOA) score were compared between the groups. JOA scoring (spinal cord function) and neurological function improvement rate (IR) were used to assess clinical efficacy.

Results: The patients were followed up for 8-36 months with an average of 19.48 months. There was no significant difference in the operation time and intraoperative blood loss between the two groups (P > 0.05). In the control group, the Cobb angles of the cervical spine were 5.13° ± 1.28°, 10.46° ± 1.07°, and 9.72° ± 1.43° before and after the operation. The observation group was followed by the Cobb angle of the cervical spine before and after the operation. They were 4.96° ± 1.39°, 11.67° ± 0.93°, and 11.13° ± 1.19°, respectively; the JOA scores before the operation, 1 week after the operation, and at the last follow-up were (8.07 ± 1.13) points and (13.57 ± 0.82) points, and (14.19 ± 0.96) points, respectively; the IR was 86.52% ± 9.33%. The preoperative, postoperative 1 week, and last follow-up JOA scores in the observation group were (8.37 ± 1.29) points, (14.11 ± 0.93) points, and (14.95 ± 0.78) points respectively. The IR was 88.74% ± 8.16% in the scores; the VAS scores were (5.54 ± 0.89) points, (1.73 ± 0.71) points, and (1.48 ± 0.52) points in the preoperative, postoperative 1 week, and last follow-up in the control group. The VAS scores were (5.81 ± 0.94) points, (1.82 ± 0.61) points, and (1.16 ± 0.49) points before, 1 week, and after the final follow-up. The JOA score and IR, VAS score and preoperative comparison between the two groups were statistically significant (P < 0.05), but there was no statistically significant difference between the two groups (P > 0.05).

Conclusion: The new open-powered nail anterior cervical plate system can achieve the same clinical effect as the traditional anterior cervical plate fixation in anterior cervical surgery, but it can simplify the operation process, effectively make up for the shortcomings of the traditional anterior cervical plate operation, and obtain satisfactory clinical application effect, which is worthy of clinical promotion.