A very rare case of locking screw pull-out after anterior cervical decompression and fusion with the Zero-profile Implant System

作者：Ma, Litai; Yang, Yi; Wu, Shan; Liu, Hao^*

来源：International Journal of Clinical and Experimental Medicine, 2016, 9(2): 4851-4854.

• Locking screw
• pull-out
• zero-profile
• anterior cervical decompress on and fusion
• ACDF

Recently a new zero-profile, standalone device (Zero-P, Synthes GmbH, Switzerland) for ACDF has been developed in an attempt to overcome the adverse effects associated with traditional cervical anterior plating such as increased dysphagia rates, tracheoesophageal lesions and plate malposition. The Zero -profile Implant System has been widely applied in ACDF but locking screw pull-out in this implant system has not been reported. A 46-year old male was referred to our department who presented with neck and shoulders pain for 23 years and numbness and weakness of right hand for 6 months. The physical examination of the patient showed hypoesthesia in the right 06 and C7 roots distribution, myodynamia of the right little finger weakened to Grade 3. Magnetic resonance image confirmed cervical disc herniations in segments C5/6 and C6/7. Anterior cervical decompression and fusion with the Zero -profile Implant System was performed via a classic right Smith-Robinson approach after induction of general anesthesia. Six months postoperative X-ray and CT scan showed a locking screw at the segment 06/7 pulled out. Considering the patient was asymptomatic, the cervical stability is reliable and no evidence of esophageal perforation, conservative treatment was recommended and the patient was followed up every six months. This first case report demonstrated that the use of locking screws in the Zero -profile Implant System also does not extinguish the risk of screw pull-out. Conservative treatment and close follow-up may be suitable for some mild pull-out patients without esophageal perforation and clinical symptom.

• 出版日期2016
• 单位四川大学