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已发表论文

使用零 P VA 系统进行陆续在两节段颈椎前路椎间盘切除融合术：一项回顾性研究

 

Authors Zhang Q, Chen Z, Lin Y, Cao P, Zhang X, Wu W, Liang Y 

Received 14 January 2025

Accepted for publication 8 April 2025

Published 16 May 2025 Volume 2025:17 Pages 213—220

DOI http://doi.org/10.2147/ORR.S517491

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Clark Hung

Qiang Zhang, Zhe Chen, Yazhou Lin, Peng Cao, Xingkai Zhang, Wenjian Wu,* Yu Liang* 

Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yu Liang, Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, People’s Republic of China, Email hugoliang@126.com Wenjian Wu, Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, People’s Republic of China, Email drwuwenjian@126.com; nuoguan45104511153@163.com

Purpose: The aim of this study was to explore short-term radiological findings after contiguous two-level ACDF with Zero-P VA devices.
Methods: Patients who underwent contiguous two-level anterior cervical discectomy and fusion (ACDF) from C3 to C7 with a Zero-P VA system were followed. Cervical anteroposterior and lateral X-rays and functional outcomes were assessed 3 months after surgery.
Results: Overall, 34.9% of patients had prosthesis subsidence and 74.6% screw loosening. Up to 46.8% of the patients with screw loosening also experienced prosthesis subsidence compared with 0 patients without screw loosening (p=0.0005). The screw-loosening rate was 91.7% in patients with poor positioning of the screw/cage and 70.6% in patients without poor positioning of the screw/cage, but no statistical difference was found between the groups (p=0.267). The subsidence rate was 50% in patients with poor positioning of the screw/cage and 31.4% in patients without poor positioning of the screw/cage, but no statistical difference was found between the groups (p=0.314). VAS scores of patients with prosthesis subsidence were much higher than those without (p=0.031), but this difference was not found for patients with or without screw loosening (p=0.116). The NDI scale was much higher in patients regradless of screw loosening or subsidence.
Conclusion: Screw loosening and prosthesis subsidence happen frequently after contiguous two-level ACDF with Zero-P VA. Screw loosening seems to be the only risk factor for prosthesis subsidence.

Keywords: contiguous two-level ACDF, Zero-P VA, screw loosening, prosthesis subsidence

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