At the end of December 2014, the spinal cord specialty group of the neurosurgery department of Qilu Hospital of Shandong University successfully performed minimally invasive decompression plus zero-cut intervertebral fusion surgery via anterior cervical microscopy for two patients with severe cervical disc herniation and cervical spinal stenosis. Although the traditional anterior cervical intervertebral fusion technique with anterior titanium plate fixation is well established, the incidence of postoperative dysphagia or foreign body sensation is generally high because of the metal titanium plate placed between the anterior edge of the vertebral body and the esophagus. The neurosurgery spinal cord technology group was the first to apply the Zero-P zero-cut intervertebral fusion device from Johnson & Johnson to perform cervical intervertebral fusion in combination with the minimally invasive decompression technique under the neurosurgery microscope, and successfully operated on the patients. Both patients recovered well and were discharged from the hospital recently. Jiang Zheng, Department of Neurosurgery, Qilu Hospital, Shandong University Case 1: A 69-year-old male was admitted to the hospital with numbness and weakness of the extremities for 2 months after neck trauma. The patient fell down accidentally at night while coughing at the bedside 2 months ago, and immediately became unconscious and woke up about 10 minutes later with inability to move his limbs and incontinence. An emergency MRI of the cervical spine was performed at a local hospital, which showed cervical marrow injury and cervical disc herniation. Conservative treatment for two months with poor results. Admission diagnosis: 1. cervical marrow injury; 2. cervical disc protrusion; 3. cervical spinal stenosis. Preoperatively, the neurosurgery department pioneered the anterior cervical zero-tangential interbody fusion technique for cervical spondylolisthesis. After admission, the patient was given further improvement of relevant examinations and a detailed diagnosis and treatment plan was formulated: 3D reconstruction of cervical CT and cervical spine plain film were performed to understand the degeneration of cervical spine. The patient’s MRI showed cervical 3/4, 4/5 and 5/6 multi-segment disc herniation and spinal stenosis, and two surgical options were available: anterior cervical and posterior cervical. Director Jiang Yuquan led the neurosurgery spinal cord team to fully discuss the patient’s condition and formulated a minimally invasive anterior cervical approach for cervical 3/4 discectomy and intervertebral fusion. After completing all the preoperative examinations and preparations, Dr. Jiang Yuquan, Director of the Department of Neurosurgery, Dr. Wang Lei, Deputy Chief Physician Jiang Zheng and Dr. Han Lizhang performed the surgery on December 23, 2014. The nucleus pulposus and fibrous ring of the cervical 3-4 intervertebral disc were removed under the microscope, and the nucleus pulposus protruding into the spinal canal was removed, and the hyperplastic bone at the posterior edge of the vertebral body was removed with a grinding drill. The posterior longitudinal ligament was excised and the dural sac was seen to be significantly inflated with adequate decompression. The Johnson & Johnson Zero-P zero-cut intervertebral fusion device was used for the first time to perform cervical intervertebral fusion. After the operation, the patient’s symptoms of numbness and weakness of the extremities were significantly improved compared with those before the operation, and he complained of no significant swallowing difficulty or swallowing discomfort. Postoperative review of cervical spine plain film and CT showed satisfactory results. Case 2: The patient was a 53-year-old male who was admitted to the hospital for 2 years due to hyperalgesia of the skin on the left side of the body. Two years ago, the patient developed pain and hyperalgesia of the skin of the left trunk without any obvious cause, which was progressively aggravated. Recently, the patient’s symptoms were significantly aggravated, and an MRI of the neck was performed at a local hospital, which showed cervical 5-6 and cervical 6-7 disc herniation, spinal cord cavitation, subcerebellar tonsillar herniation, and cervical degeneration. Admission diagnosis: 1. subcerebellar tonsillar herniation deformity; 2. spinal cord cavitation; 3. cervical disc herniation and spinal stenosis. The patient’s spinal cord was cavernous due to the combination of submicrocephalic tonsillar herniation and cervical disc herniation, which caused symptoms. After thorough discussion, the neurosurgical spinal column specialty group formulated a combined surgical plan of posterior cervical suboccipital decompression + anterior cervical microdiscectomy and intervertebral fusion for the patient. The operation was performed on December 23, 2014, and the posterior suboccipital decompression with a small bone window was performed first. The anterior cervical 5-6 discectomy and cervical interbody fusion with Johnson & Johnson’s Zero-P zero-cut interbody fusion device were performed under the microscope. After surgery, the patient’s trunk skin sensory abnormalities were significantly improved compared with those before surgery, and he complained of no significant swallowing difficulty or swallowing discomfort. Postoperative review of cervical spine plain film and CT showed satisfactory results. Figure 4 Comparison of zero-tangential cervical interbody fusion and traditional cervical interbody fusion The neurosurgery department was the first to carry out anterior cervical zero-tangential interbody fusion for cervical spondylosis A. Traditional cervical interbody fusion B. Zero-tangential cervical interbody fusion (Case 2) In recent years, the spinal and spinal cord specialty group of our neurosurgery department, led by Jiang Yuquan, has successfully carried out a large number of anterior and posterior minimally invasive surgical treatments for cervical spondylosis. Recently, the Department of Neurosurgery was the first to perform anterior cervical interbody fusion surgery using the Zero-P zero-cut interbody fusion device in our hospital, and none of the patients had any significant swallowing difficulties or foreign body sensation after surgery, which greatly reduced the postoperative discomfort of patients. Compared with the traditional anterior cervical interbody fusion with anterior titanium plate fixation, the incidence of dysphagia, foreign body sensation and postoperative discomfort was significantly reduced after Zero-P zero-tangency interbody fusion.