Clinical and radiological outcomes of a cervical cage with integrated fixation

Lonjon, Nicolas; Favreul, E.; Huppert, Jean; Lioret, Eric; Delhaye, Manuel; Mraidi, Ramzi

doi:10.1097/md.0000000000014097

Cited by 13 publications

(23 citation statements)

References 46 publications

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“…The ROI-C device system, an anatomical PEEK cage and two VerteBRIDGE self-locking plates, is designed for the elimination of the basic disadvantage of stand-alone cage. 17 Multiple studies, 17 18 22 23 28 30 33 including our study, showed low subsidence rate. Most patients with cage subsidence did not experience any symptoms and they achieved fusion in the final follow-up.…”

Section: Discussionmentioning

confidence: 49%

“…However, postoperative cage subsidence should be aware in patients with multilevel ACDF using selflocking stand-alone cage. 34,35 According to the study of 90 patients who underwent ACDF with the ROI-C device by Lonjon et al, 22 they reported anchoring plate fracture in 5 (2%) from 249 plates with no clinical consequence. The mechanism of anchoring plate fracture remains unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Self-locking stand-alone cages have been increasingly used in ACDF to avoid complications associated with anterior cervical plates. 22 The ROI-C cage is a cervical interbody cage composed of radiolucent PEEK optima using the VerteBRIDGE double anchoring system for initial and long-term stability. It was designed for having zero profile without hardware protruding outside the vertebral bodies.…”

Section: Discussionmentioning

confidence: 99%

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Zero-Profile Anchored Spacer (ROI-C) in the Treatment of Cervical Adjacent Segment Disease

et al. 2022

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Background Self-locking stand-alone cages have increasingly been used in anterior cervical discectomy and fusion (ACDF) cervical degenerative disc disease. We studied clinical and radiological outcomes of patients who underwent zero-profile anchored spacer (ROI-C)–assisted ACDF without anterior plate fixation in cervical adjacent segment disease. Materials and Methods Fifteen patients suffering from cervical adjacent segment disease with various symptoms, such as radiculopathy, myelopathy, or both, were retrospectively evaluated. The cervical adjacent segment disease was confirmed by plain radiographs and magnetic resonance imaging. The patients underwent radiological evaluation to assess cervical curvature, intervertebral height, fusion, and subsidence. Clinical assessment was graded using a visual analog scale, Modified Japanese Orthopedic Association score, and the Neck Disability Index. Results There were 19 levels of operation. Single-level ACDF was performed in 11 patients and two level in 4 patients. In the postoperative period, our study revealed significant improvement in the clinical outcome. The cervical curvature and intervertebral height were significantly improved at 12-months follow-up (p < 0.05). The fusion rate was 100%, whereas subsidence occurred in 5.3% but produced no symptoms. Of the 19 operated segment, 2 (5.3%) from 38 VerteBRIDGE plates had breakage. There was only one case of mild dysphagia, which resolved in less than 2 weeks. Conclusion This study indicates that zero-profile anchored spacer (ROI-C) in the treatment of cervical adjacent segment disease provides improvement of clinical outcomes, restoration of lordosis, high fusion rate, and low incidence of dysphagia. However, subsidence and breakage of VerteBRIDGE plate occurred in 5.3% cases, but did not cause clinical symptoms.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Zero-Profile Anchored Spacer (ROI-C) in the Treatment of Cervical Adjacent Segment Disease

et al. 2022

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“…Various analysis has equated the radiological and clinical outcomes of cage-andplate fixation and cage-only practices [7][8] . In few analyses, lower subsidence rates and higher fusion percentage is noticed with cage-and-plate fixation while additional analyses exhibited no alteration among the two techniques 9 . In newly published metaanalysis, no differences in radiological and clinical results were found amid the cage and fixation of plate and cage-only group at ACDF 1-level surgery [10][11] .…”

Section: Introductionmentioning

confidence: 91%

Comparison of Radiological Outcome in Anterior Cervical Discectomy and Fusion: Cage-Only v/s Cage and Plate Fixation

Razaque¹,

Zeeshan²,

Uddin³

et al. 2022

PJMHS

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Aim: A retrospective analysis of the outcome of anterior cervical discectomy and fusion comparing cage-only and cage-and-plate fixation on the basis of radiographic changes. Setting: In the department of Neurosurgery of a tertiary care hospital for two-year duration from January 2019 to December 2020. Methods: 56 patients who endured one-level ACDF (n = 34) and two-level ACDF (n = 22) for cervical disc disease were enrolled in the study and underwent a 12-months follow-up. Patients were separated according to cervical level and divided into cage-only group (ACDF-C) and cage-and-plate fixation group (ACDF-CP). The subsidence and status of fusion were evaluated on the radiography. Results: Comparing the ACDF-C with ACDF-CP at one level, the subsidence was detected in 50% of patients in the former group and in 33.3% of cases in the later at 12 months follow up. The two groups do not have statistically significant variance in terms of occurrence percentage (p = 0.32). In the two levels comparison of ACDF, ACDF-C had significantly more subsidence (75%) than the ACDF-CP group (28.5%; p= 0.046). The rate of fusion in single level ACDF of ACDF-C was not much different on statistics from that in the ACDF-CP group (87.5% and 88.8%, p= 0.43). The fusion was also similar in the two levels ACDF (ACDF-C= 87.5% and ACDF-CP= 92.8%; p= 0.30). Conclusions: This study’s radiological outcome did not exhibit any extra advantage of plate fixation compared to the cage-only in the 1-level ACDF subjects; however in ACDF at 2-level, a subsidence is much more probable without fixation of plate and therefore adding a plate to cage must be taken important. Keywords: cervical plate, cervical discectomy, spinal fusion, subsidence.

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“…The incidence of postoperative dysphagia in patients undergoing ACDF with zero-profile stand-alone cervical cages has been reported as 3.7% [57]. ACDF with the use of zero-profile intervertebral cages has shown a rate of transient postoperative dysphagia at 1.1%-7.9% [58][59][60][61][62]. Among 25 patients treated with ACDF with a zero-profile cage, three patients presented with mild transient dysphagia that resolved at two weeks and two patients had moderate dysphagia that resolved at five weeks [63].…”

Section: Acdf Devices and Disc Replacementmentioning

confidence: 99%

Dysphagia as a Postoperative Complication of Anterior Cervical Discectomy and Fusion

Tsalimas¹,

Evangelopoulos²,

Benetos³

et al. 2022

Cureus

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Anterior cervical discectomy and fusion (ACDF), despite its possible complications, remains the gold standard for the surgical treatment of patients with radiculopathy and/or myelopathy caused by cervical intervertebral disc herniation or spondylosis. Despite its high rate of incidence, postoperative dysphagia following ACDF is still poorly understood; its pathogenesis remains relatively unknown, and its risk factors are still a subject of debate.The aim of this study is to review the incidence, pathogenesis, diagnosis, and methods of prevention of dysphagia in ACDF patients. To this end, a literature review was conducted based on the PubMed internet database. Article titles were searched by using the following keywords: "dysphagia" and "anterior cervical discectomy and fusion" or "ACDF". The search was limited to prospective clinical studies evaluating dysphagia after ACDF surgery. Studies published in non-English languages, retrospective studies, cadaveric studies, reviews, case reports, study protocols, and commentary studies were excluded.Initially, 335 studies were identified after a primary search. After the application of the exclusion criteria, 73 studies remained for the final analysis. This literature review focused on identifying the rate of dysphagia and the various risk factors leading to this complication by comparing and evaluating the current literature with a wide spectrum of heterogeneity concerning patients, surgeons, and surgical techniques. A mean dysphagia rate of 19.4% (95% CI: 9.6%-29.1%) based on the findings of the included studies correlating dysphagia directly with ACDF procedures was calculated. Various established risk factors leading to dysphagia include the female sex, smoking, the surgical approach, rhBMP-2 use, and multilevel surgery, while zero-profile devices seem to reduce dysphagia risk. The diagnosis is based on clinical and radiological findings, especially prevertebral soft-tissue swelling. However, videofluoroscopic and endoscopic studies have been recently used for the evaluation of dysphagia. The role of local administration of steroids in the prevention of dysphagia has not yet been clarified. This review underscores the prevailing rudimentary understanding of the problem of dysphagia after ACDF procedures and highlights the need for more sensitive, factor-specific studies for understanding the impact of various risk factors on the incidence rate of dysphagia.

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Clinical and radiological outcomes of a cervical cage with integrated fixation

Cited by 13 publications

References 46 publications

Zero-Profile Anchored Spacer (ROI-C) in the Treatment of Cervical Adjacent Segment Disease

Zero-Profile Anchored Spacer (ROI-C) in the Treatment of Cervical Adjacent Segment Disease

Comparison of Radiological Outcome in Anterior Cervical Discectomy and Fusion: Cage-Only v/s Cage and Plate Fixation

Dysphagia as a Postoperative Complication of Anterior Cervical Discectomy and Fusion

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