{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:54:14Z","timestamp":1772160854989,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T00:00:00Z","timestamp":1638057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the risk factors for dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero\u2010P Implant System by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis of 260 patients who underwent ACDF with the Zero\u2010P Implant System and had at least 2 year of follow\u2010up were performed. All patients were divided into a non\u2010dysphagia group and a dysphagia group. Sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft\u2010tissue thickness, the levels of surgery, O\u2010C\n                      <jats:sub>2<\/jats:sub>\n                      angle, C\n                      <jats:sub>2\u20137<\/jats:sub>\n                      angle, T\n                      <jats:sub>1<\/jats:sub>\n                      slope and segmental angle were analyzed. The Modified Japanese Orthopaedic Association (JOA) scoring system was used to determine functional status. NDI was used to evaluate neck pain and disability. The Bazaz grading system was chosen to evaluate dysphagia after surgery. Postoperative cerebrospinal fluid (CSF) leakage, infection, and dysphagia were recorded in both groups. An independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test was used to compare quantitative variables, a chi\u2010square test was used to compare qualitative data between the two groups. To eliminate the influence of confounding factors, logistic regression was performed for multifactor regression of factors. The results were regarded as significant when the\n                      <jats:italic>P<\/jats:italic>\n                      \u2010values were less than 0.05 in this study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, the non\u2010dysphagia group comprised 70 patients and the dysphagia group comprised 190 patients, with an average age of 58.33 \u00b1\u20094.68\u2009years (ranging, 42\u201382\u2009years). These patients were followed up for 28.5 \u00b1\u20093.5 months (range, 24\u201332 months). For clinical outcomes, both groups demonstrated significant improvement in the NDI and JOA scores (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001). According to the Bazaz dysphagia grading system, mild, moderate, and severe dysphagia were found in 50, 17, and 3 patients, respectively. In total, 37.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a026) had resolved by 3 month, 38.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a027) by 6 months, and 17.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012) by 12 months. Chi\u2010square test results indicated that number of operated levels, operation time dT1 slope, dO\u2010C\n                      <jats:sub>2<\/jats:sub>\n                      angle, dC\n                      <jats:sub>2\u20137<\/jats:sub>\n                      angle, segmental angle and dPSTT were associated with a high incidence of dysphagia. Multivariate logistic regression analysis showed that number of operated levels, operation time, dC\n                      <jats:sub>2\u20137<\/jats:sub>\n                      angle and dPSTT were significantly associated with postoperative dysphagia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      More operated levels, more operation time, more dC\n                      <jats:sub>2\u20137<\/jats:sub>\n                      angle and dPSTT were the risk factors for postoperative dysphagia. In additional, sufficient preoperative preparation, evaluation combined with proficient and precise surgical treatment were suggested to reduce the incidence of postoperative dysphagia when ACDF was performed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.13170","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T01:56:19Z","timestamp":1638150979000},"page":"149-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Risk Factors for Dysphagia after Anterior Cervical Discectomy and Fusion with the\n                    <scp>Zero\u2010P<\/scp>\n                    implant system: A Study with Minimum of 2\u2009Years Follow\u2010up"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-3224","authenticated-orcid":false,"given":"Rong","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Xinghua People's Hospital  Taizhou China"},{"name":"Department of Orthopaedics Affiliated Hospital of Nantong University  Nantong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhu\u2010yong","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Xinghua People's Hospital  Taizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing\u2010dong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Xinghua People's Hospital  Taizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhu\u2010qiu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Xinghua People's Hospital  Taizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Affiliated Hospital of Nantong University  Nantong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1757-7861.2011.00169.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12565"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13033"},{"key":"e_1_2_9_5_1","first-page":"1","article-title":"A single\u2010center retrospective analysis of 3\u2010 or 4\u2010level anterior cervical discectomy and fusion: surgical outcomes in 66 patients","author":"McClure JJ","year":"2020","journal-title":"J Neurosurg Spine"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12634"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199904000-00151"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2002.12.1.5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-010-0821-4"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13026"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-016-1274-6"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-017-5311-4"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3507-4"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2620-5"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2020.10.007"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000177211.44960.71"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2006.04.003"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1283-3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200103150-00015"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568218755141"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e31819e2ab8"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4914-5"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1597-9"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200211150-00007"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181f9f714"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000240656.79060.18"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311201102"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000142626.90278.9e"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31821cbba5"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1354253"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.SPINE141004"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.2.SPINE08385"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.5.SPINE09182"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003813"},{"key":"e_1_2_9_35_1","first-page":"1","article-title":"Applicability of cervical sagittal vertical axis, cervical lordosis, and T1 slope on pain and disability outcomes after anterior cervical discectomy and fusion in patients without deformity","author":"Lau D","year":"2019","journal-title":"J Neurosurg Spine"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.5.SPINE171232"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2963-6"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31828a2992"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1731-8"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13170","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.13170","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:28:04Z","timestamp":1693182484000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,28]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/os.13170"],"URL":"https:\/\/doi.org\/10.1111\/os.13170","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-393070\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-138933\/v1","asserted-by":"object"}]},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,28]]},"assertion":[{"value":"2021-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}