AI Article Synopsis

  • Anterior Cervical Discectomy and Fusion (ACDF) is the primary treatment for cervical spondylosis when medication fails, but there's no consensus on a preferred implant.
  • The study evaluated the radiological outcomes of two types of implants—the stand-alone PEEK cage and the Zero-profile augmented screw implant (Z-P)—in 233 ACDF cases in Northern Ireland.
  • Results showed that the Z-P implant was superior in maintaining disc height and restoring cervical alignment compared to the PEEK cage, suggesting it may be a better choice for surgical procedures.

Article Abstract

Introduction Anterior Cervical Discectomy and Fusion (ACDF) is the gold standard treatment for symptomatic cervical spondylosis refractory to analgesic medical management. Currently, there are numerous approaches and devices used; however, there is no single implant that is preferred for this procedure. The aim of this study is to evaluate the radiological outcomes of ACDF procedures performed in the regional spinal surgery centre in Northern Ireland. The results of this study will aid surgical decision-making, specifically with regard to the choice of implant. The implants that will be assessed in this study are the stand-alone polyetheretherketone (PEEK) cage (Cage) and the Zero-profile augmented screw implant (Z-P). Methods A total of 420 ACDF cases were reviewed retrospectively. Following exclusion and inclusion criteria, 233 cases were reviewed. In the Z-P group, there were 117 patients, with 116 in the Cage group. Radiographic assessment was carried out at the pre-operative stage, day one post-operation, and follow-up (> three months). Measured parameters included segmental disc height, segmental Cobb angle, and spondylolisthesis displacement distance. Results Patient characteristic features showed no significant difference between the two groups (p>0.05) and no significant difference in mean follow-up time (p=0.146). The Z-P implant was superior in increasing and maintaining disc height post-operatively (+0.4±0.94mm, 5.20±0.66mm) compared to the Cage (+0.1±1.00mm, 4.40±0.95mm) (p<0.001). Z-P was also more successful in restoring and maintaining cervical lordosis in comparison to the Cage group, as it had a significantly smaller kyphosis incidence (0.85% vs. 34.5%) at follow-up (p<0.001). Conclusions Results of this study show a more advantageous outcome in the Zero-profile group as it restores and maintains both disc height and cervical lordosis; it is also more successful in treating spondylolisthesis. This study advocates cautious endorsement of the use of the Zero-profile implant in ACDF procedures for symptomatic cervical disc disease.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188236PMC
http://dx.doi.org/10.7759/cureus.38864DOI Listing

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