BACKGROUND:It is notable to treat cervical spondylosis using the anterior cervical discectomy and fusion, but there are such complications as cervical instability and low fusion rate. Titanium plate with cage can solve those defects, while anterior unfamiliar matter and dysphagia appear. A new anterior cervical interbody fusionZero-Pwith support and fixation function has been widely used in clinic.
OBJECTIVE:To analyze early stability in repairing cervical spondylosis using a newZero-Pinterbody fixation and fusion system, and compare with a titanium plate with cage interbody fixation andfusion system.
METHODS:We retrospectively analyzed the clinical date of 31 patients with cervical spondylosis who underwent the anterior cervical discectomy and fusion in the Department of Orthopedics, Affiliated Hospital of Jiangsu University between August 2010 and August 2014. Fifteen patients were treated with aZero-P implant (Zero-Pgroup) and sixteen patients with a titanium plate with cage (cage group). We recorded operation time, intraoperative blood loss, preoperative and postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores, postoperative incidence of dysphagia and degeneration rate of adjacent joint.
RESULTS AND CONCLUSION:(1) Postoperative symptoms were apparently improved, without severe complications in both groups. (2) Operation time and intraoperative blood loss were better in theZero-P group than in the cage group (P< 0.05). (3) Postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores were significantly improved in both groups (P< 0.05). The recovery rate of Japanese Orthopedic Association scores was similar between the two groups (81%, 81%;P> 0.05). (4) Mild dysphagia was experienced by one case (7%) in theZero-Pgroup, but nine cases (44%) in the cage group. Significant difference in the incidence of dysphagia was detected between the two groups after treatment (P=0.037). However, no significant difference in degeneration rate was detectable between the two groups (P=0.48). (5) These findings verify that in the anteriorcervical discectomy and fusion, the new Zero-Pand titanium plate with cage interbody fixation and fusion system are effective choices for cervical spondylosis. However, theZero-Pinterbody fixation and fusion system showed a low incidence of postoperative dysphagia and better stability.

BACKGROUND:Once lumbar degenerative diseases merge with lumbar spinal stenosis, lumbar instability and degenerative scoliosis, surgical therapy is required for corresponding clinical symptoms, and the usage of internal fixators cannot be inevitable. Osteoporosis is rather common in the elderly. Therefore, how to implant stable pedicle screw fixation system in serious osteoporosis patients wil be a big difficulty. In recent years, some studies have proven the biomechanical stability of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw in the vertebral body, so it becomes very hot in the spine surgery. OBJECTIVE: To explore the clinical efficacy of the use of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation for the treatment of lumbar degenerative disease accompanied with osteoporosis. METHODS:Thirty-one patients with lumbar degenerative disease accompanied with osteoporosis from Jun 2008 to Jan 2013 were selected, including 11 males and 20 females with an average age of 73.5 years (range, 65-86 years). There were 14 cases of lumbar degenerative stenosis, 9 of lumbar intervertebral disc herniation combined with segmental instability, 6 of lumbar degenerative spondylolisthesis, and 2 of lumbar degenerative scoliosis. The patients were treated with lumbar canal decompression, fusion and polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation according to their clinical features and imaging data. Visual analog scale for pain evaluation was used before and after fixation, the Japanese Orthopaedic Association (JOA) scale was used for assessment of neurological function and life skils before internal fixation and during folow-up. RESULTS AND CONCLUSION:Al cases were folowed up for 40 months (range, 36-48months). No screw breakage, rod breakage, screw extraction, loosening, pseudoarticulation formation, or incision infection was found. The postoperative visual analog scale score and the JOA score was remarkably improved (P < 0.05). For patients suffering from lumbar degenerative disease accompanied with osteoporosis, polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation is helpful for increasing the stabilization of screw and preventing from loosening and dislocation of the screws, and thereby beneficial for improvement and maintenance of clinical efficacy.