Zero-P and ROI-C implants versus traditional titanium plate with cage to treat cervical spondylotic myelopathy: clinical and radiological results with 5 years of follow-up

Abstract

Abstract Background Anterior cervical discectomy and fusion (ACDF) is the gold standard for treating cervical spondylotic myelopathy (CSM). While implanting plates in ACDF may increase the risk of complications. Zero-P and ROI-C implants have been gradually applied for CSM. Methods 150 patients with CSM were retrospectively analyzed from January 2013 to July 2016. Group A consisted of 56 patients who received traditional titanium plates with cage. 94 patients underwent ACDF using zero-profile implants and were divided into 50 patients with the Zero-P device (Group B) and 44 with the ROI-C device (Group C). Related indicators were measured and compared. The clinical outcomes were evaluated by JOA, VAS, and NDI scores. Results Compared with group A, group B and C had a less blood loss and shorter operation time. The JOA and VAS scores improved significantly from pre-operative to 3 months postoperative and last follow-up in three groups. The cervical physiological curvature and segmental lordosis at final follow-up were higher than that of pre-operation (p < 0.05). Dysphagia rate, adjacent level degeneration rate, and Osteophyma rate was the highest in group A (p < 0.05). The bone graft fusion was achieved at the final follow-up in three groups. There were no statistical significance in fusion rate and subsidence rate among the three groups. Conclusions ACDF with Zero-P or ROI-C implants can also obtain satisfactory clinical outcomes compared to traditional titanium plate with cage after 5 years follow-up. The zero-profile implant devices carry a simple operation, short operation time, less intraoperation blood loss, and incidence of dysphagia.