Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, 215101, P.R. China.
The People's Hospital of SND, Suzhou, 215129, P.R. China.
BMC Musculoskelet Disord. 2024 Oct 25;25(1):848. doi: 10.1186/s12891-024-07985-y.
The self-locking cage (ROI-C, LDR, Troyes, France) has been clinically applied in the treatment of cervical degenerative disc disease (CDDD). However, only a few long-term clinical and radiographic studies have been conducted on the treatment of spinal cord injury without fracture or dislocation (SCIWFD) so far. A comparison between ACDF with either ROI-C or CCP was performed to determine the better treatment for SCIWFD.
A total of 83 patients who underwent ACDF using either ROI-C or CCP were reviewed for radiological and clinical outcomes. The cohort comprised 60 males and 23 females, aged between 32 and 88 years old, with an average age of 58.23 years. All patients exhibited symptoms of nerve injury, including limb numbness, muscle weakness, hypoesthesia or urinary dysfunction. The preoperative ASIA classification of spinal nerve function: 7 cases of grade A, 23 cases of grade B, 34 cases of grade C and 19 cases of grade D were included in the study.
A total of 48 patients underwent ACDF with ROI-C, while 35 patients received a conventional cage-plate. They were studied with a follow-up of 28.63 ± 17.41 months and 29.48 ± 15.43 months respectively. No significant difference was found in blood loss, JOA and ASIA between the two groups. No significant difference was found in cervical lordosis (CL) (P > 0.05). However, statistical difference was found in disc height of fused segment and T1 slope between the two groups (P < 0.05). No statistical difference was in the incidence of cage subsidence (P > 0.05). There was significant difference in the incidence of dysphagia. Both of two groups achieved bony fusion at final follow-up.
Our study demonstrated that ROI-C has the same efficacy as CCP in improving the cervical stability in treatment of SCIWFD. The migration of cage didn't occur in ROI-C group at final follow-up, showing steadily fixed in cervical column. Moreover, the ROI-C does have the advantages of good therapeutic effect, mis-invasive, shorter operation time and fewer complications.
自锁定笼（ROI-C，LDR，特鲁瓦，法国）已在治疗颈椎退行性疾病（CDDD）的临床中应用。然而，迄今为止，对于无骨折脱位脊髓损伤（SCIWFD）的治疗，仅有少数长期临床和影像学研究。为了确定治疗 SCIWFD 的更好方法，我们比较了 ACDF 联合 ROI-C 或 CCP 的治疗效果。
回顾性分析了 83 例采用 ROI-C 或 CCP 行 ACDF 的患者的影像学和临床结果。该队列包括 60 名男性和 23 名女性，年龄 32 至 88 岁，平均年龄 58.23 岁。所有患者均有神经损伤症状，包括肢体麻木、肌无力、感觉减退或尿功能障碍。术前 ASIA 脊髓神经功能分级：纳入研究的有 7 例 A 级、23 例 B 级、34 例 C 级和 19 例 D 级。
48 例患者行 ROI-C 辅助 ACDF，35 例行常规 cage-plate。随访时间分别为 28.63±17.41 个月和 29.48±15.43 个月。两组间出血量、JOA 评分和 ASIA 评分差异无统计学意义。两组间颈椎前凸角（CL）差异无统计学意义（P>0.05）。但融合节段椎间盘高度和 T1 斜率差异有统计学意义（P<0.05）。两组间 cage 下沉发生率差异无统计学意义（P>0.05）。两组间吞咽困难发生率差异有统计学意义。两组最终随访均获得骨性融合。
本研究表明，ROI-C 在改善 SCIWFD 颈椎稳定性方面与 CCP 具有相同的疗效。ROI-C 组在最终随访时 cage 无迁移，在颈椎柱中稳定固定。此外，ROI-C 具有疗效好、微创、手术时间短、并发症少等优点。
