scholarly journals The Effect of the Difference in the C2-7 Angle on the Occurrence of Dysphagia after Anterior Cervical Discectomy and Fusion with the Zero-P Implant System

2020 ◽  
Author(s):  
Cheng-Yi Huang ◽  
Yang Meng ◽  
Bei-Yu Wang ◽  
Jie Yu ◽  
Chen Ding ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Anterior Cervical Discectomy ◽  
Multiple Factor Analysis ◽  
Related Factors ◽  
Cervical Discectomy ◽  
Estimated Blood Loss ◽  
Prevertebral Soft Tissue ◽  
The Difference ◽  
One Year ◽  
Implant System

Abstract Background: To investigate the effect of the difference in the C2-7 angle (C2-7A) on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.Methods: A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up was performed from January 2011 to November 2018. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2-7As (dC2-7A) on postoperative dysphagia. Furthermore, other possible related factors including the difference between postoperative and preoperative O-C2 angles (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgical segments were analyzed.Results: One hundred thirty-nine patients were included in the non-dysphagia group, and 42 patients were included in the dysphagia group. Single-factor analysis showed that smoking, PSTS and the dC2-7A were significantly different between the two groups (P<0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and he dC2-7A (P>0.05). The results of multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and the dC2-7A were significantly associated with the incidence of dysphagia (P<0.05).Conclusions: The postoperative C2-7A has an important effect on the occurrence of dysphagia in patients undergoing interbody fusion surgery with the Zero-P Implant System.

scholarly journals The effect of the difference in C2-7 angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the Zero-P Implant System

2020 ◽  
Author(s):  
Chengyi Huang ◽  
Yang Meng ◽  
Beiyu Wang ◽  
Jie Yu ◽  
Chen Ding ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Anterior Cervical Discectomy ◽  
Multiple Factor Analysis ◽  
Related Factors ◽  
Cervical Discectomy ◽  
Estimated Blood Loss ◽  
Prevertebral Soft Tissue ◽  
The Difference ◽  
One Year ◽  
Implant System

Abstract Objectives: To investigate the effect of the difference in C2-7 angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.Methods: A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2-7 angle (dC2-7A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed.Results: In total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC2-7A were significantly different between the two groups (P<0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC2-7A (P>0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC2-7A were significantly associated with the incidence of dysphagia (P<0.05).Conclusions: The postoperative C2-7 angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.

scholarly journals The effect of the difference in the C2-7 angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the Zero-P Implant System

2020 ◽  
Author(s):  
Chengyi Huang ◽  
Yang Meng ◽  
Beiyu Wang ◽  
Jie Yu ◽  
Chen Ding ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Anterior Cervical Discectomy ◽  
Multiple Factor Analysis ◽  
Related Factors ◽  
Cervical Discectomy ◽  
Estimated Blood Loss ◽  
Prevertebral Soft Tissue ◽  
The Difference ◽  
One Year ◽  
Implant System

Abstract Objectives: To investigate the effect of the difference in C2-7 angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.Methods: A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2-7 angle (dC2-7A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed.Results: In total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC2-7A were significantly different between the two groups (P<0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC2-7A (P>0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC2-7A were significantly associated with the incidence of dysphagia (P<0.05).Conclusions: The postoperative C2-7 angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.

scholarly journals The effect of the difference in C2–7 angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the zero-P implant system

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng-Yi Huang ◽  
Yang Meng ◽  
Bei-Yu Wang ◽  
Jie Yu ◽  
Chen Ding ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Anterior Cervical Discectomy ◽  
Multiple Factor Analysis ◽  
Related Factors ◽  
Cervical Discectomy ◽  
Estimated Blood Loss ◽  
Prevertebral Soft Tissue ◽  
The Difference ◽  
One Year ◽  
Implant System

Abstract Objectives To investigate the effect of the difference in C2–7 angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System. Methods A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2–7 angle (dC2–7A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed. Results In total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC2–7A were significantly different between the two groups (P < 0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC2–7A (P > 0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC2–7A were significantly associated with the incidence of dysphagia (P < 0.05). Conclusions The postoperative C2–7 angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.

scholarly journals Comparison between selective caudal fixed screw construct and all variable screw construct in anterior cervical discectomy and fusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae Jun Yang ◽  
Sehan Park ◽  
Seongyun Park
Keyword(s):  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Disc Space ◽  
Cervical Discectomy ◽  
Locking Mechanism ◽  
Adjacent Disc ◽  
One Year ◽  
The Stability ◽  
Retrospective Comparative Study ◽  
Caudal Level

AbstractThis retrospective comparative study aimed to compare the efficacy of selective caudal fixed screw constructs with all variable screw constructs in anterior cervical discectomy and fusion (ACDF). Thirty-five patients who underwent surgery using selective caudal fixed screw construct (SF group) were compared with 44 patients who underwent surgery using all variable constructs (AV group). The fusion rate, subsidence, adjacent level ossification development (ALOD), adjacent segmental disease (ASD), and plate-adjacent disc space distance were assessed. The one-year fusion rates assessed by computed tomography bone bridging and interspinous motion as well as the significant subsidence rate did not differ significantly between the AV and SF groups. The ALOD and ASD rates and plate-adjacent disc space distances did not significantly differ between the two groups at both the cranial and caudal adjacent levels. The number of operated levels was significantly associated with pseudarthrosis in the logistic regression analysis. The stability provided by the locking mechanism of the fixed screw did not lead to an increased fusion rate at the caudal level. Therefore, the screw type should be selected based on individual patient’s anatomy and surgeon’s experience without concern for increased complications caused by screw type.

scholarly journals Comparison Between Selective Caudal Fixed Screw Construct and All Variable Screw Construct in Anterior Cervical Discectomy and Fusion

2020 ◽  
Author(s):  
Jae Jun Yang ◽  
Sehan Park ◽  
Seongyun Park
Keyword(s):  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Disc Space ◽  
Cervical Discectomy ◽  
Locking Mechanism ◽  
Adjacent Disc ◽  
One Year ◽  
The Stability ◽  
Retrospective Comparative Study ◽  
Caudal Level

Abstract Objectives: This retrospective comparative study aimed to compare the efficacy of selective caudal fixed screw constructs with all variable screw constructs in anterior cervical discectomy and fusion (ACDF). Methods: Thirty-five patients who underwent surgery using selective caudal fixed screw construct (SF group) were compared with 44 patients who underwent surgery using all variable constructs (AV group). The fusion rate, subsidence, adjacent level ossification development (ALOD), adjacent segmental disease (ASD), and plate-adjacent disc space distance were assessed.Results: The one-year fusion rates assessed by computed tomography bone bridging and interspinous motion as well as the significant subsidence rate did not differ significantly between the AV and SF groups. The ALOD and ASD rates and plate-adjacent disc space distances did not significantly differ between the two groups at both the cranial and caudal adjacent levels. The number of operated levels was significantly associated with pseudarthrosis in the logistic regression analysis.Conclusion: The stability provided by the locking mechanism of the fixed screw did not lead to an increased fusion rate at the caudal level. Therefore, the screw type should be selected based on individual patient’s anatomy and surgeon’s experience without concern for increased complications caused by screw type.

scholarly journals Impact of local steroid application on dysphagia following an anterior cervical discectomy and fusion: results of a prospective, randomized single-blind trial

2018 ◽  
Vol 29 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
Daniel D. Bohl ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Anterior Cervical Discectomy ◽  
Retropharyngeal Abscess ◽  
Cervical Discectomy ◽  
Air Index ◽  
Estimated Blood Loss ◽  
Patient Reported ◽  
Chi Square Analysis ◽  
The Impact ◽  
Single Blind

OBJECTIVEIntraoperative local steroid application has been theorized to reduce swelling and improve swallowing in the immediate period following anterior cervical discectomy and fusion (ACDF). Therefore, the purpose of this study was to quantify the impact of intraoperative local steroid application on patient-reported swallow function and swelling after ACDF.METHODSA prospective, randomized single-blind controlled trial was conducted. A priori power analysis determined that 104 subjects were needed to detect an 8-point difference in the Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire score. One hundred four patients undergoing 1- to 3-level ACDF procedures for degenerative spinal pathology were randomized to Depo-Medrol (DEPO) or no Depo-Medrol (NODEPO) cohorts. Prior to surgical closure, patients received 1 ml of either Depo-Medrol (DEPO) or saline (NODEPO) applied to a Gelfoam carrier at the surgical site. Patients were blinded to the application of steroid or saline following surgery. The SWAL-QOL questionnaire was administered both pre- and postoperatively. A ratio of the prevertebral swelling distance to the anteroposterior diameter of each vertebral body level was calculated at the involved levels ± 1 level by using pre- and postoperative lateral radiographs. The ratios of all levels were averaged and multiplied by 100 to obtain a swelling index. An air index was calculated in the same manner but using the tracheal air window diameter in place of the prevertebral swelling distance. Statistical analysis was performed using the Student t-test and chi-square analysis. Statistical significance was set at p < 0.05.RESULTSOf the 104 patients, 55 (52.9%) were randomized to the DEPO cohort and 49 (47.1%) to the NODEPO group. No differences in baseline patient demographics or preoperative characteristics were demonstrated between the two cohorts. Similarly, estimated blood loss and length of hospitalization did not differ between the cohorts. Neither was there a difference in the mean change in the scaled total SWAL-QOL score, swelling index, and air index between the groups at any time point. Furthermore, no complications were observed in either group (retropharyngeal abscess or esophageal perforation).CONCLUSIONSThe results of this prospective, randomized single-blind study did not demonstrate an impact of local intraoperative steroid application on patient-reported swallowing function or swelling following ACDF. Neither did the administration of Depo-Medrol lead to an earlier hospital discharge than that in the NODEPO cohort. These results suggest that intraoperative local steroid administration may not provide an additional benefit to patients undergoing ACDF procedures.■ CLASSIFICATION OF EVIDENCE Type of question: therapeutic; study design: randomized controlled trial; evidence: Class I.Clinical trial registration no.: NCT03311425 (clinicaltrials.gov)

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