title: A Comparison of Zero-Profile Devices and Artificial Cervical Disks in Patients With 2 Noncontiguous Levels of Cervical Spondylosis.
abstract: METHODS
  A prospective randomized and controlled study of 30 patients with 2 noncontiguous levels of cervical spondylosis.
  
  
  OBJECTIVE
  To compare the clinical outcome between zero-profile devices and artificial cervical disks for noncontiguous cervical spondylosis.
  
  
  BACKGROUND
  Noncontiguous cervical spondylosis is an especial degenerative disease of the cervical spine. Some controversy exists over the choice of surgical procedure and fusion levels for it because of the viewpoint that the stress at levels adjacent to a fusion mass will increase. The increased stress will lead to the adjacent segment degeneration (ASD). According to the viewpoint, the intermediate segment will bear more stress after both superior and inferior segments' fusion. Cervical disk arthroplasty is an alternative to fusion because of its motion-preserving. Few comparative studies have been conducted on arthrodesis with zero-prolife devices and arthroplasty with artificial cervical disks for noncontiguous cervical spondylosis.
  
  
  METHODS
  Thirty patients with 2 noncontiguous levels of cervical spondylosis were enrolled and assigned to either group A (receiving arthroplasty using artificial cervical disks) and group Z (receiving arthrodesis using zero-profile devices). The clinical outcomes were assessed by the mean operative time, blood loss, Japanese Orthopedic Association (JOA) score, Neck Dysfunction Index (NDI), cervical lordosis, fusion rate, and complications.
  
  
  RESULTS
  The mean follow-up was 32.4 months. There were no significant differences between the 2 groups in the blood loss, JOA score, NDI score, and cervical lordosis except operative time. The mean operative time of group A was shorter than that of group Z. Both the 2 groups demonstrated a significant increase in JOA score, NDI score, and cervical lordosis. The fusion rate was 100% at 12 months postoperatively in group Z. There was no significant difference between the 2 groups in complications except the ASD. Three patients had radiologic ASD at the final follow-up in group Z, and none in group A.
  
  
  CONCLUSIONS
  Both zero-prolife devices and artificial cervical disks are generally effective and safe in the treatment of 2 noncontiguous levels of cervical spondylosis. However, in view of occurrence of the radiologic ASD and operative time, we prefer to artificial cervical disks if indications are well controlled.
authors.affiliation: *Department of Orthopedics, Qilu Hospital of Shandong University†Department of Orthopedics, the 88th Hospital of China People's Liberation Army, Shandong Province, People's Republic of China.
authors.forename: Sun
authors.initials: S
authors.lastname: Qizhi
authors.forename: Sun
authors.initials: S
authors.lastname: Lei
authors.forename: Li
authors.initials: L
authors.lastname: Peijia
authors.forename: Zhao
authors.initials: Z
authors.lastname: Hanping
authors.forename: Hu
authors.initials: H
authors.lastname: Hongwei
authors.forename: Chen
authors.initials: C
authors.lastname: Junsheng
authors.forename: Li
authors.initials: L
authors.lastname: Jianmin
mesh_terms: D000328:Adult; D003710:Demography; D017586:Diskectomy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome