Evaluation of outcome of zero-profile implant for anterior cervical discectomy and fusion in traumatic cervical sub-axial disc injury in Indian population: A prospective study

Abstract

Objective: The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease in last decade.However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. The purpose of this study was to assess the overall outcome of Zero-Profile implant for ACDF in traumatic cervical sub-axial three columnar injury with disc prolapse. Methods: 20 patients with post-traumatic sub-axial three columnar cervical injury with single level disc prolapse and subsequent neural compression were underwent ACDF with Zero-profile implant and followed up for a minimum of one year. Apart from per-operative parameters, Cobb angle, operative segmental angle, fusion rate and subsidence were assessed radiologically. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Odom’s criteria. Results: Fusion rate at the end of one year was 90% (19/20). Mean Cobb angles and operative segmental angles increased by 3.6 degrees and 5.5 degrees respectively, over the preoperative value. Cage subsidence occurred in 3 cases (15%). Mean pre-operative JOA score was 13.4, improved post-operatively to 15.2. According to Odom’s criteria, 13 patients (65%) had belonged to Excellent and Good category, five patients (25%) in Fair category and two patients (10%) remained in Poor category. Conclusion: Zero-profile implants are effective in treating three columnar post-traumatic sub axial cervical disc prolapse in performing ACDF as it is biomechanically stable, restores the radiological parameters and can produce functional improvement.