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Objectives  To investigate the effect of the difference in C 2–7  angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.    Methods  A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C 2–7  angle (dC 2–7 A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed.    Results  In total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC 2–7 A were significantly different between the two groups ( P  < 0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC 2–7 A ( P  > 0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC 2–7 A were significantly associated with the incidence of dysphagia (P < 0.05).    Conclusions  The postoperative C 2–7  angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.

The effect of the difference in C2–7 angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the zero-P implant system