Comparison of Clinical Outcomes Following Anterior Cervical Discectomy and Fusion with Zero-Profile Anchored Spacer-ROI-C-Fixation and Combined Intervertebral Cage and Anterior Cervical Discectomy and Fusion: A Retrospective Study from a Single Center

Abstract

Background The aim of this study was to compare the outcomes following anterior cervical discectomy and fusion with zero-profile anchored spacer-ROI-C-fixation (ROI-C) vs combined intervertebral cage and anterior cervical discectomy and fusion (ACDF). Material/Methods We retrospectively analyzed 87 patients who underwent operations between January 2015 and January 2019, including 42 patients that underwent ROI-C treatment (group A) and 45 that were treated by the ACDF approach (group B). Operative duration, blood loss, dysphagia, Neck Disability Index scores (NDI), Japanese Orthopaedic Association scores (JOA), and other complications were compared between these groups. In addition, implant settlement, fusion, and cervical Cobb angle were assessed via imaging analyses. Results Patients in group A and group B were followed for 22.6±3.3 months and 27.1±3.5 months, respectively (range: 13–30 months). Relative to preoperative values, JOA scores were increased and NDI scores were reduced in both groups following treatment ( P <0.05), with comparable outcomes between groups ( P >0.05). However, operative duration, intraoperative blood loss, and postoperative complications did differ significantly between these groups ( P <0.05). Specifically, rates of short-term dysphagia were lower and recovery time was faster in group A relative to group B ( P <0.05). Conclusions The findings from this study showed that ROI-C fixation achieved satisfactory outcomes, improved cervical curvature, restored intervertebral height, and was associated with shorter operative duration, reduced blood loss, and less dysphagia.

Zero-profile anchored spacer versus conventional plate-cage construct in bilevel anterior cervical discectomy and fusion: a systematic review and meta-analysis

“…Concerning cage subsidence, there was no significant difference between ZAS and PCC in bilevel ACDF. Our result is similar to the findings of He et al and Zhao et al, which may be inferred from the similar biomechanical properties of the two devices and similar fusion rates [ 43 , 47 ]. Overall, our findings suggested the adoption of ZAS in bilevel ACDF did not raise the incidence of cage sinking in comparison to PCC.…”

“…Dysphagia remains the most commonly reported complication of ACDF and is often attributed to the introduction of anterior plates and oesophageal traction intraoperatively. Studies showed ZAS significantly minimised the incidence of postoperative dysphagia in ACDF [ 32 , 38 , 43 ]. Our results demonstrated that the postoperative dysphagia rate was significantly smaller in ZAS group than in PCC group in bilevel ACDF.…”

Are all Cages Created Equal? Analysis of Cervical Cage Malfunctions Using FDA MAUDE Database

“…The majority of the intraoperative malfunctions relating to the ROI-C cage in the present study were due to breakage of the anchors, a complication that has not been previously described. Previous studies have assessed outcomes and postoperative complications following ACDF with the ROI-C cage and concluded that it was an acceptable alternative to the classic plate and cage constructs 24,25 . In aggregate, these data suggest that although these anchors frequently fail intraoperatively, they may not be associated with significant postoperative complications.…”

“…Previous studies have assessed outcomes and postoperative complications following ACDF with the ROI-C cage and concluded that it was an acceptable alternative to the classic plate and cage constructs. 24,25 In aggregate, these data suggest that although these anchors frequently fail intraoperatively, they may not be associated with significant postoperative complications. Copyright r 2023 Wolters Kluwer Health, Inc. All rights reserved.…”

Comparing Clinical and Radiographic Outcomes Between the Self-locking Stand-Alone Cage and Conventional Cage-Plate Construct: a 5-year Retrospective Cohort Study

“…Several clinical studies have shown that the short-term outcome of SA cages is as good as that of conventional ACDF with a CPC. 6,7 However, there are few reports on its clinical efficacy, particularly with more than three years of follow-up evaluation.…”