Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China,
Clin Interv Aging. 2018 Dec 14;13:2543-2551. doi: 10.2147/CIA.S182969. eCollection 2018.
To investigate the early and mid-term efficacy and safety of the bridge-type ROI-C interbody fusion cage system in the treatment of cervical spondylosis with osteoporosis during anterior cervical discectomy and fusion (ACDF).
The clinical data from 24 cervical spondylosis patients with osteoporosis treated with ACDF were retrospectively analyzed. All patients were treated with ROI-C cage. Double-energy X-ray absorptiometry (DEXA) was used to measure the bone mineral density (BMD). The cervical sagittal radiographic parameters were measured and compared using X-ray including C2-C7 Cobb angle, segmental angle (SA), cervical vertebral bow depth, and height of operation segment (HOS). Postoperative dysphagia was recorded according to the Bazaz score. The Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI) scores were used to evaluate the clinical outcomes at different time points. Odom and Vaccaro criteria were used to assess the surgical effects and to evaluate the fusion of the bone graft.
The mean duration of the postoperative follow-up was 27.4±5.7 months (ranging from 21 to 36 months). The JOA scores and NDI scores at 3 months post operation and at the time of final follow-up were significantly different from those before surgery (<0.05). Two patients had mild dysphagia after surgery, but it disappeared after symptomatic treatment for 3-5 days. Sagittal radiographic outcomes were significantly improved at 3 months post operation (<0.05). At the time of final follow-up, the radiographic parameters were well maintained and were not significantly different compared with 3 months post operation (>0.05).
The ROI-C cage system is safe and effective for use in patients undergoing anterior cervical spondylosis surgery for osteoporosis treatment. It results in a positive effect on bone graft fusion, is able to effectively improve cervical curvature, restores intervertebral height, and reduces the incidence of postoperative dysphagia. The clinical effects were positive at the early and middle postoperative stages.
探讨桥型 ROI-C 椎间融合 cage 系统在颈椎前路减压融合术（ACDF）治疗伴骨质疏松的颈椎病中的早期和中期疗效及安全性。
回顾性分析 24 例伴骨质疏松的颈椎病患者行 ACDF 治疗的临床资料。所有患者均采用 ROI-C cage 治疗。采用双能 X 线吸收法（DEXA）测量骨密度（BMD）。X 线测量颈椎矢状位影像学参数，包括 C2-C7 Cobb 角、节段角（SA）、颈椎曲度深度和手术节段高度（HOS）。根据 Bazaz 评分记录术后吞咽困难情况。采用日本矫形协会（JOA）评分和颈痛残疾指数（NDI）评分评估不同时间点的临床疗效。采用 Odom 和 Vaccaro 标准评估手术效果和植骨融合情况。
术后随访时间平均为 27.4±5.7 个月（21～36 个月）。术后 3 个月和末次随访时的 JOA 评分和 NDI 评分均明显优于术前（<0.05）。术后 2 例患者出现轻度吞咽困难，经对症治疗 3～5 天后消失。术后 3 个月矢状位影像学结果明显改善（<0.05）。末次随访时，影像学参数与术后 3 个月相比保持良好，差异无统计学意义（>0.05）。
ROI-C 椎间融合 cage 系统治疗伴骨质疏松的颈椎病前路手术安全有效，对植骨融合有积极作用，能有效改善颈椎曲度，恢复椎间高度，降低术后吞咽困难的发生率。术后早期和中期临床效果良好。
