{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:07:57Z","timestamp":1790208477361,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2019YFQ0002"],"award-info":[{"award-number":["2019YFQ0002"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The unclear clinical outcomes of two different zero\u2010profile implants with different number of screws in hybrid surgery restricts the choice of patient\u2010specific implants. This study aims to compare two different implants on its postoperative subsidence, motion stabilization and clinical outcomes. It also provides references to the most reasonable implant choice in fusion surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study. From February 2014 to March 2022, 173 patients who underwent hybrid surgery were included. Among them, 122 received surgery with a four screw implant, while 51 received a two screw implant. We analyzed the significance of patient\u2010specific factors, radiographic factors and clinical outcomes. The Wilcoxon rank sum test, <jats:italic>t<\/jats:italic> tests\/analysis of variance (ANOVA) test and stepwise multivariate logistic regression were adopted for statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No statistically significant difference was observed between the two screw and four screw groups in terms of immediate, middle, and long\u2010term stability and fusion rate (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). However, the two screws group had higher FSU height subsidence at 3, 6, and 12\u2009months postoperatively and higher rates of significant subsidence at three and 6\u2009months postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Both groups showed significant clinical improvements at the final follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Two screw and four screw implants provide comparable stability, fusion rates and clinical outcomes. However, the two screw implant was inferior to the four screw implant in subsidence prevention. Therefore, the two\u2010screw implant is non\u2010inferior to the four\u2010screw implant in most patients. It can be used as the priority choice in the fusion segment by its easy manageability. However, the patients with a high risk of subsidence such as multilevel surgery, the elderly, lower BMD, bad cervical alignment should receive a four screw implant rather than a two screw implant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14139","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T03:19:36Z","timestamp":1718853576000},"page":"2355-2363","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Does Screw Number of Zero\u2010profile Implants in Fusion Segment Influence Intervertebral Stability?"],"prefix":"10.1111","volume":"16","author":[{"given":"Zihan","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Orthopedics Orthopedic Research Institute West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiao","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Orthopedic Research Institute West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaqing","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Orthopedic Research Institute West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5330-4193","authenticated-orcid":false,"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Orthopedic Research Institute West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics West China Hospital Sichuan University\/West China School of Nursing Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Operating Room West China Hospital Sichuan University  Chengdu China"},{"name":"West China School of Nursing Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Orthopedic Research Institute West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8843-2240","authenticated-orcid":false,"given":"Yang","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Orthopedic Research Institute West China Hospital Sichuan University  Chengdu 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