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用于颈椎前路椎间盘切除融合术的ROI-C零轮廓锚定椎间融合器:生物力学特征及临床疗效

The ROI-C zero-profile anchored spacer for anterior cervical discectomy and fusion: biomechanical profile and clinical outcomes.

作者信息

Bucci Michael N, Oh Dennis, Cowan R Scott, Davis Reginald J, Jackson Robert J, Tyndall Dwight S, Nehls Daniel

机构信息

Piedmont Spine and Neurosurgical Group, PA, Greenville, SC, USA.

Baystate Medical Center, Springfield, MA, USA.

出版信息

Med Devices (Auckl). 2017 Apr 18;10:61-69. doi: 10.2147/MDER.S127133. eCollection 2017.

Abstract

INTRODUCTION

Anterior cervical discectomy and fusion (ACDF) has been the gold standard for treating cervical degenerative disc disease (cDDD). The use of anterior plates in ACDF poses an increased risk of complications such as screw or plate dislodgement, soft tissue injury, esophagus perforation, and dysphagia. The ROI-C™ implant system consists of a zero-profile interbody fusion cage with self-locking plates designed for stand-alone fusion without external plates or screws.

OBJECTIVE

The purpose of this report is to describe the ROI-C™ implant system with VerteBRIDGE™ anchor plates, including indications for use, surgical technique, preclinical testing, and clinical study results. The objectives of the clinical study were to assess fusion status, incidence of dysphagia and other device-related complications, and patient reported outcomes.

METHODS

This was a retrospective, multicenter cohort study of 110 patients who underwent ACDF with ROI-C at seven study centers. Patient charts and radiographs were reviewed for any complications or device malfunction. The final follow-up was conducted prospectively and included collection of neck disability index, and visual analog scale (VAS) neck and arm pain scores.

RESULTS

The mean operation time was 73 minutes, and mean blood loss was 25 mL (range 0-75 mL). Mean follow-up was 20.7 months (range 9.5-42.2). Dysphagia was reported in two patients (1.8%), and 99.1% of patients achieved fusion. One patient had radiographically confirmed pseudarthrosis at 12 months that was asymptomatic and did not require surgery. One patient had subsequent surgery owing to adjacent level degeneration. The mean neck disability index, VAS neck pain, and VAS right and left arm pain scores at final follow-up were 19, 26.5, 12.5, and 15.3, respectively.

CONCLUSION

The ROI-C interbody cage with VerteBRIDGE anchor plates achieved a high rate of fusion, with a low incidence of dysphagia. These patients had similar or better outcomes compared to ACDF with anterior plating reported in peer-reviewed literature.

摘要

引言

颈椎前路椎间盘切除融合术(ACDF)一直是治疗颈椎退行性椎间盘疾病(cDDD)的金标准。在ACDF中使用前路钢板会增加并发症风险,如螺钉或钢板移位、软组织损伤、食管穿孔和吞咽困难。ROI-C™植入系统由一个零轮廓椎间融合器和自锁钢板组成,设计用于独立融合,无需外部钢板或螺钉。

目的

本报告旨在描述带有VerteBRIDGE™锚定钢板的ROI-C™植入系统,包括使用指征、手术技术、临床前测试和临床研究结果。临床研究的目的是评估融合状态、吞咽困难及其他与器械相关并发症的发生率,以及患者报告的结局。

方法

这是一项对110例在7个研究中心接受ROI-C辅助ACDF手术患者的回顾性多中心队列研究。对患者病历和X线片进行检查,以发现任何并发症或器械故障。最终随访是前瞻性进行的,包括收集颈部功能障碍指数以及视觉模拟量表(VAS)颈部和手臂疼痛评分。

结果

平均手术时间为73分钟,平均失血量为25毫升(范围0 - 75毫升)。平均随访时间为20.7个月(范围9.5 - 42.2个月)。两名患者(1.8%)报告有吞咽困难,99.1%的患者实现融合。一名患者在12个月时经影像学证实为假关节形成,但无症状,无需手术。一名患者因相邻节段退变而接受了后续手术。最终随访时,平均颈部功能障碍指数、VAS颈部疼痛评分以及VAS右臂和左臂疼痛评分分别为19、26.5、12.5和15.3。

结论

带有VerteBRIDGE锚定钢板的ROI-C椎间融合器实现了高融合率,吞咽困难发生率低。与同行评审文献中报道的使用前路钢板的ACDF相比,这些患者的结局相似或更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94c0/5403002/a36f031b3ab1/mder-10-061Fig1.jpg

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