Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Surgical Procedure
2.2. Clinical Measures
2.3. Statistical Analysis
3. Results
3.1. Demographics
3.2. Clinical Outcomes
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Covariate | All Patients n = 166 | Stand Alone n = 109 | Cervical Plate n = 57 | p-Value |
---|---|---|---|---|
Demographics | ||||
Age, n (SD) | 53 (13) | 52 (14) | 54 (13) | 0.50 |
Female, n (%) | 92 (55) | 66 (61) | 26 (46) | 0.07 |
Medical Comorbidities | ||||
BMI, mean (SD) | 29 (9) | 28 (6) | 30 (6) | 0.05 |
Diabetes Mellitus, n (%) | 24 (14) | 15 (14) | 9 (16) | 0.73 |
Current Smoker, n (%) | 45 (27) | 30 (28) | 15 (26) | 0.87 |
Former Smoker, n (%) | 47 (28) | 24 (22) | 23 (40) | 0.03 |
Osteoporosis, n (%) | 3 (2) | 3 (3) | 0 | 0.08 |
Treatments, n (%) | ||||
Number of Medication, mean (SD) | 6 (4) | 6 (4) | 6 (4) | 0.72 |
1 opioid | 50 (30) | 32 (29) | 18 (32) | 0.77 |
2+ opioids | 11 (7) | 8 (7) | 3 (5) | 0.60 |
1 depression medication | 44 (27) | 33 (30) | 11 (19) | 0.11 |
2+ depression medications | 10 (6) | 7 (6) | 3 (5) | 0.76 |
Pregabalin or Gabapentin | 40 (24) | 30 (28) | 10 (18) | 0.17 |
Chronic NSAID | 58 (35) | 40 (37) | 18 (32) | 0.44 |
Chronic Steroid | 13 (8) | 10 (9) | 3 (5) | 0.60 |
Physical Therapy | 98 (59) | 67 (61) | 31 (54) | 0.52 |
Epidural Steroid Injection | 22 (13) | 17 (16) | 5 (9) | 0.25 |
Clinical presentation, n (%) | ||||
Radiculopathy | 92 (55) | 66 (61) | 26 (46) | 0.07 |
Myelopathy | 37 (22) | 15 (14) | 22 (39) | 0.001 |
Myeloradiculopathy | 37 (22) | 28 (26) | 9 (16) | 0.13 |
Covariate | All Patients | Stand Alone | Cervical Plate | p-Value |
---|---|---|---|---|
Number of Levels of Surgery | ||||
1 | 85 (51) | 59 (54) | 26 (46) | 0.30 |
2 | 65 (39) | 37 (34) | 28 (49) | 0.63 |
3 | 16 (10) | 13 (12) | 3 (5) | 0.13 |
Levels of Surgery, n | ||||
C2-C3 | 25 | 13 | 12 | 0.15 |
C3-C4 | 66 | 42 | 24 | 0.66 |
C4-C5 | 133 | 88 | 45 | 0.79 |
C5-C6 | 133 | 89 | 44 | 0.51 |
C6-C7 | 68 | 48 | 20 | 0.26 |
C7-T1 | 52 | 35 | 17 | 0.76 |
Total number of levels | 477 | 315 | 162 | |
Length of Surgery, mean (SD) | 150 min (64) | 126 min (46) | 194 min (69) | <0.001 |
Blood Loss, n (%) | ||||
0–50 mL | 132 (80) | 85 (78) | 47 (82) | 0.49 |
51–100 mL | 30 (18) | 24 (22) | 6 (10) | 0.05 |
>100 mL | 4 (2) | 0 | 4 (7) | 0.05 |
CSF leak, n (%) | 1 (1) | 0 | 1 (2) | 0.32 |
Length of stay, mean (SD) | 1.7 (1) | 1.5 (1) | 2.1 (2) | 0.006 |
Dysphagia at 3 months, n (%) | ||||
None | 79 (96) | 52 (98) | 27 (93) | 0.34 |
Mild | 3 (4) | 1 (2) | 2 (7) | 0.34 |
Moderate | 0 | 0 | 0 | N/A |
Steroid use, n (%) | 10 (6) | 9 (8) | 1 (2) | 0.07 |
Patient Group | All Patients (n = 74) | Stand Alone (n = 43) | Cervical Plate (n = 31) | |||
---|---|---|---|---|---|---|
Nurick Score | Baseline | Last Follow-Up | Baseline | Last Follow-Up | Baseline | Last Follow-Up |
0 | 0 | 55 (74) | 0 | 36 (84) | 0 | 19 (61) |
1 | 21 (28) | 12 (16) | 11 (26) | 3 (7) | 10 (32) | 9 (29) |
2 | 41 (55) | 5 (7) | 25 (58) | 4 (9) | 16 (52) | 1 (3) |
3 | 8 (11) | 1 (1) | 6 (14) | 0 | 2 (7) | 1 (3) |
4 | 3 (4) | 0 | 1 (2) | 0 | 2 (7) | 0 |
5 | 0 | 0 | 0 | 0 | 0 | 0 |
6 | 1 (1) | 1 (1) | 0 | 0 | 1 (3) | 1 (3) |
Covariates | OR (95% CI) | p-Value |
---|---|---|
Patient Characteristics | ||
Age | 0.99 (0.97–1.04) | 0.79 |
Sex (Female) | 1.21 (0.27–2.30) | 0.71 |
Diabetes | 0.44 (0.12–1.23) | 0.14 |
Surgery Characteristics | ||
Stand-Alone Zero Profile | 0.67 (0.14–1.61) | 0.49 |
Length of Stay | 0.5 (0.35–0.85) | 0.003 |
Number of levels of Surgery | ||
1 level | 1 | NA |
2 levels | 1.99 (0.15–1.70) | 0.22 |
3 levels | 3.56 (0.77–21) | 0.25 |
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Sommaruga, S.; Camara-Quintana, J.; Patel, K.; Nouri, A.; Tessitore, E.; Molliqaj, G.; Panchagnula, S.; Robinson, M.; Virojanapa, J.; Sun, X.; et al. Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients. J. Clin. Med. 2021, 10, 3076. https://doi.org/10.3390/jcm10143076
Sommaruga S, Camara-Quintana J, Patel K, Nouri A, Tessitore E, Molliqaj G, Panchagnula S, Robinson M, Virojanapa J, Sun X, et al. Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients. Journal of Clinical Medicine. 2021; 10(14):3076. https://doi.org/10.3390/jcm10143076
Chicago/Turabian StyleSommaruga, Samuel, Joaquin Camara-Quintana, Kishan Patel, Aria Nouri, Enrico Tessitore, Granit Molliqaj, Shreyas Panchagnula, Michael Robinson, Justin Virojanapa, Xin Sun, and et al. 2021. "Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients" Journal of Clinical Medicine 10, no. 14: 3076. https://doi.org/10.3390/jcm10143076
APA StyleSommaruga, S., Camara-Quintana, J., Patel, K., Nouri, A., Tessitore, E., Molliqaj, G., Panchagnula, S., Robinson, M., Virojanapa, J., Sun, X., Melnikov, F., Kolb, L., Schaller, K., Abbed, K., & Cheng, J. (2021). Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients. Journal of Clinical Medicine, 10(14), 3076. https://doi.org/10.3390/jcm10143076