Outcome Evaluation of Zero-Profile Device Used for Single-Level Anterior Cervical Discectomy and Fusion with Osteoporosis Compared without Osteoporosis: A Minimum Three-Year Follow-Up Study

Abstract Objective To compare the mid-term efficacy and safety of anterior cervical discectomy and fusion (ACDF) treatment with Zero-Profile device between cervical degenerative disc disease (CDDD) with osteoporosis and non-osteoporosis. Methods Retrospective study was conducted on elderly CDDD patients treated by single level ACDF with Zero-Profile device. Patients were divided into group A (osteoporosis) and group B (non-osteoporosis) according to the result of bone mineral density. The clinical outcomes (Japanese Orthopaedic Association score (JOA), Neck Disability Index (NDI) score, Visual Analogue Scale (VAS) score and Short form 36 (SF-36) score), radiological outcome (cervical lordosis and fusion rate) and complications were reviewed at each follow-up time. Results All procedures were successfully performed in all patients. The JOA score, NDI score, VAS score, SF-36 score and cervical lordosis were significantly improved postoperatively in both groups (P 0.05). There was no significant difference regarding fusion rate at 3 months postoperatively (88.9% in Group A and 90.0% in Group B), dysphagia rate at 1 months postoperatively (11.1% in Group A and 15.0% in Group B) and cage subsidence rate at final follow-up (11.1% in Group A and 10.0% in Group B) (P > 0.05). All patients achieved solid fusion and no patient had dysphagia at final follow-up. Conclusions ACDF with Zero-Profile can be used as an effective and reliable treatment for the single level CDDD with osteoporosis.