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BACKGROUND: At present, anterior cervical discectomy and fusion is the “gold standard” for treatment of cervical spondylosis. The cervical zero-notch anterior interbody fusion cage is gradually being promoted and applied in clinical practice, with good clinical efficacy and imaging results. OBJECTIVE: To evaluate the mid-term outcome of cervical spondylotic myelopathy treated with variable-angle zero-notch anterior interbody fusion system. METHODS: Totally 81 patients with cervical spondylotic myelopathy treated in First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2015 to January 2018 were included in this study. Among them, 42 patients received anterior cervical discectomy and decompression and fusion using variable-angle zero-notch anterior interbody fusion system (trial group); 39 patients received anterior cervical discectomy and decompression and fusion using traditional titanium plate-cage system (control group). Visual Analog Scale score, Japanese Orthopaedic Association score, Cobb-C angle and Cobb-S angle of cervical spine, interbody fusion, and complications were compared between the two groups. The protocols were approved by the Ethics Committee of First Affiliated Hospital of Guangzhou University of Chinese Medicine (approval No. JY2020199). RESULTS AND CONCLUSION: (1) Visual Analog Scale score and Japanese Orthopaedic Association score were significantly improved after surgery compared with those before surgery in both groups (P < 0.05). No significant differences in Visual Analog Scale score and Japanese Orthopaedic Association score were detected between the two groups (P > 0.05). (2) Cobb-S angle was significantly improved at 3 days and 30 months after surgery compared with that before surgery in both groups (P < 0.05). Cobb-C angle was significantly improved at 3 days after surgery compared with that before surgery in the trial group (P < 0.05). Cobb-C angle was significantly improved at 3 days and 30 months after surgery compared with that before surgery in the control group (P < 0.05). (3) The rate of complete fusion was 98% in the trial group and 100% in the control group. (4) The rate of the fusion cage sinking in the trial group was higher than that in the control group (24%, 3%, P < 0.05); the incidence of postoperative dysphagia was lower than that in the control group (2%, 38%, P < 0.05); and the incidence of adjacent intervertebral disc degeneration was lower than that in the control group (2%, 18%, P < 0.05). (5) The results have shown that variable-angle zeronotch anterior interbody fusion system for cervical spondylotic myelopathy can effectively improve the symptoms and reduce postoperative complications. However, the incidence of fusion cage sinking was higher than that of traditional titanium plate-cage system. The change of the overall curvature of the cervical spine needs long-term observation and follow-up. The mid-term efficacy of the operation is generally good. [ABSTRACT FROM AUTHOR]

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Purpose Numerous studies have applied a variety of methods to assess paraspinal muscle degeneration. However, the methodological differences in imaging evaluation may lead to imprecise or inconsistent results. This article aimed to provide a pragmatic summary review of the current imaging modalities, measurement protocols, and imaging parameters in the evaluation of paraspinal muscle fat infiltration (FI) in MRI studies. Methods: Web of Science, EMBASE, and PubMed were searched from January 2005 to March 2020 to identify studies that examined the FI of paraspinal muscles on MRI among patients with lumbar degenerative diseases. Results: Intramyocellular lipids measured by magnetic resonance spectroscopy and FI measured by chemical‐shift MRI were both correlated to low back pain and several degenerative lumbar diseases, whereas results on the relationship between FI and degenerative lumbar pathologies using conventional MRI were conflicting. Multi‐segment measurement of FI at the lesion segment and adjacent segments could be a prognostic indicator for lumbar surgery. Most studies adopted the center of the intervertebral disc or endplate as the level of slice to evaluate the FI. Compared with visual semiquantitative assessment, quantitative parameters appeared to be precise for eliminating individual or modality differences. It has been demonstrated that fat CSA/total CSA (based on area) and muscle–fat index (based on signal intensity) as quantitative FI parameters are associated with multiple lumbar diseases and clinical outcomes after surgery. Conclusion: Having a good command of the methodology of paraspinal muscle FI on MRI was effective for diagnosis and prognosis in clinical practice. [ABSTRACT FROM AUTHOR]