Contiguous Two-Level Anterior Cervical Discectomy and Fusion Using Zero-P VA System: A Retrospective Study

Area of Science:

• Spine surgery
• Orthopedic implants
• Radiology

Background:

• Anterior cervical discectomy and fusion (ACDF) is a common procedure for cervical spine pathologies.
• Zero-P VA devices are utilized in ACDF to promote fusion and stability.
• Understanding short-term radiological outcomes is crucial for evaluating implant performance and patient recovery.

Purpose of the Study:

• To investigate short-term radiological findings following contiguous two-level ACDF using Zero-P VA devices.
• To assess the incidence of prosthesis subsidence and screw loosening.
• To identify potential risk factors and their impact on functional outcomes.

Main Methods:

• Retrospective analysis of patients undergoing contiguous two-level ACDF (C3-C7) with Zero-P VA.
• Postoperative assessment at 3 months using anteroposterior and lateral cervical X-rays.
• Evaluation of functional outcomes using Visual Analog Scale (VAS) and Neck Disability Index (NDI).

Main Results:

• High rates of prosthesis subsidence (34.9%) and screw loosening (74.6%) were observed.
• Screw loosening was significantly associated with prosthesis subsidence (p=0.0005).
• Prosthesis subsidence correlated with higher VAS scores, while NDI scores were elevated regardless of screw loosening or subsidence.

Conclusions:

• Contiguous two-level ACDF with Zero-P VA is associated with frequent screw loosening and prosthesis subsidence.
• Screw loosening appears to be a primary risk factor for prosthesis subsidence.
• These findings highlight the need for careful surgical technique and monitoring to mitigate adverse radiological events.