The use of a stand-alone interbody fusion cage in subaxial cervical spine trauma: a preliminary report

J Neurol Surg A Cent Eur Neurosurg. 2015 Jan;76(1):13-9. doi: 10.1055/s-0034-1368092. Epub 2014 Mar 28.

Abstract

Background: Anterior spinal surgery has a predominant role in the treatment of traumatic lesions of the subaxial cervical spine. Plating is considered indispensable to achieve stability but may cause dysphagia, dysphonia, and adjacent-level ossification. Zero-P (Synthes GmbH, Oberdorf, Switzerland), an anchored interdisc spacer, can be used without an associated plate. The present study aimed to test if this new implant would be associated with a low rate of dysphagia and other short-term complications compared with the standard for anterior spinal fusion surgery and would be able to achieve a solid fusion and maintain correct metamere alignment.

Material and methods: This is a preliminary presentation of a clinical case series of patients with subaxial cervical injuries who underwent anterior interbody fusion. From July 2009 until September 2011, 12 patients were treated with a Zero-P cage. The data for analysis included operating time compared with the standard for spinal fusion surgery with a cage plus plate construct, intraoperative blood loss, clinical and radiographic results, and complications.

Results: In the postoperative period no patient had neurologic worsening. One patient experienced transient dysphonia and moderate dysphagia. All the patients were followed up for a minimum of 6 months (mean: 13 months; range: 6-27 months). Stability and fusion were obtained in all patients together with correct metamere alignment.

Conclusion: We presented the preliminary results of a clinical case series. Our results support the initiation of prospective randomized trials with more patients and longer follow-up.

MeSH terms

  • Adolescent
  • Adult
  • Cervical Vertebrae / injuries
  • Cervical Vertebrae / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Internal Fixators / adverse effects
  • Internal Fixators / standards*
  • Male
  • Middle Aged
  • Spinal Fusion / methods*
  • Treatment Outcome
  • Young Adult