We compared the clinical and radiological results of patients who received a Perfect-C implant, a Zero-P implant, or a titanium plate with a PEEK cage for the treatment of cervical degenerative disc disease. The Zero-P has many advantages that are similar to those of the Perfect-C. In general, the Zero-profile integrated plate and spacer device (Zero-P, Synthes, Oberdorf, Switzerland) is employed for the treatment of cervical degenerative disc disease and disc herniation. Minimizing the contact between the plate and anterior soft tissue creates less HO and is associated with less dysphagia. In contrast, the screws of the Zero-P implant enter the cancellous bone of the vertebral body through the endplate, and the screws of plate-with-cage implants directly enter the cortical bone (Fig. The Perfect-C is composed of a polyetheretherketone (PEEK) cage with two screws, which enter the cancellous bone of the vertebral body through the corner between the cortical bone and the endplate (Fig. In fact, the Perfect-C was developed before introduction of the Zero-P in Korea in 2013. A report outlining the potential applications of the Perfect-C was later published in 2011. In 2009, a new integrated cage and plate device (Perfect-C, Seohancare, Korea) was developed, which integrates the benefits of an anterior cervical plate and a fusion cage to prevent complications such as heterotopic ossification (HO) (Fig. Of particular concern, anterior osteophyte development and anterior longitudinal ligament ossification have been appeared after anterior cervical fusion. However, complications such as screw or plate displacement, soft tissue damage, esophageal perforation, and dysphasia have been reported. Titanium plates and cages support many advantages over other approaches for ACDF, including a higher fusion rate, disc height restoration, better cervical lordosis and alignment. Long-term follow-up revealed that ACDF is an effective method but that up to 25% of patients may develop radiculopathic or myelopathic symptoms. In 1958, Smith and Cloward initially introduced ACDF, which provided both neural decompression and spine stability. The Perfect-C implant was associated with shorter operation times and hospitalization durations, less blood loss, and lower subsidence rates compared with the Zero-P implant or the titanium plate with a PEEK cage.Īnterior cervical discectomy and fusion (ACDF) is regarded as the proper surgical treatment for symptomatic cervical degenerative disc disease of patients when conservative therapy is not effective. However, the Perfect-C implant has many advantages over both the Zero-P implant and conventional plate-cage treatments. The Perfect-C, Zero-P, and plate-with-cage devices are effective for treating single-level cervical degenerative disc disease. Fusion occurred in 37 cases (90%) in the Perfect-C group, in 31 cases (86%) in the Zero-P group, and in 68 cases (95%) in the plate-with-cage group. Subsidence occurred in five cases (14%) in the Perfect-C group, in nine cases (25%) in the Zero-P group, and in 15 cases (21%) in the plate-with-cage group. The cephalad and caudal plate-to-disc distance (PDD) and the cephalad and caudal PDD/anterior body height (ABH) were significantly greater in the Perfect-C and Zero-P groups than in the plate-with-cage group ( P < 0.05). At the last follow-up visit, heterotopic ossification (HO) was not observed in any cases (0%) in the Perfect-C and Zero-P groups but was noted in 21 cases (30%) in the plate-with-cage group. The length of the operation, intraoperative blood loss, and duration of hospitalization were significantly lower in the Perfect-C group than in the Zero-P and plate-with-cage groups ( P < 0.05). We conducted a retrospective study to compare the clinical and radiological results among the three groups. We enrolled 148 patients who were subjected to single-level ACDF with one of the following three surgical devices: a Perfect-C implant (41 patients), a Zero-P implant (36 patients), or a titanium plate with a polyetheretherketone (PEEK) cage (71 patients). We intended to analyze the efficacy of a new integrated cage and plate device called Perfect-C for anterior cervical discectomy and fusion (ACDF) to cure single-level cervical degenerative disc disease.
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