Efficacy And Sagittal Parameters Of The Zero Notch Bridge Locking Fusion(ROI-C)in The Treatment Of Cervical Spondylosis With Osteoporosis In The Elderly

Objecive:To investigate the early and mid-term efficacy and sagittal parameter analysis of the zero-profile bridge locking fusion(ROI-C)system in anterior cervical corpectomy decompression and fusion(ACDF)for the treatment of cervical spondylosis with osteoporosis in the elderly.Methods:Retrospective analysis of 27 patients with cervical spondylosis with osteoporosis treated with ROI-C intervertebral fusion in our hospital from June 2017 to June 2020.Among them,there were 10 cases of spinal cervical spondylosis,14 cases of neurogenic cervical spondylosis,and 3 cases of mixed cervical spondylosis.There were 10 male cases and 17 female cases,aged 60-76 years,with an average of 68.2 years.The postoperative follow-up was 12-24 months,with an average of 17.4 months.A total of 38 ROI-C fusion devices were placed in 18 cases with single-segment lesions,7 cases with double-segment lesions,and 2 cases with triple-segment lesions.The operating time and intraoperative bleeding were recorded,and the Japanese Orthopaedic Association(JOA)score,visual analogue scale(VAS)and Neck Disability Index(NDI)were used to evaluate the neurological function and BMD before and after surgery.The severity of postoperative dysphagia was assessed by the Bazaz criteria and the C2-7 Cobb angle,fusion stage cobb angle,intervertebral height,and cervical vertebral bow depth were observed by imaging data before and after surgery.Results:All 27 patients obtained good anesthetic surgical results,with a mean operative time of 85.47±8.83 min and a mean operative bleeding volume of 21.19±6.54 ml.The JOA score,VAS score,and NDI score of the 27 patients obtained significant improvement from the preoperative level to the last follow-up.C2-7Cobb angle increased from 13.15 ± 4.53°preoperatively to 21.24±5.04° at the last follow-up(P<0.05);the cobb angle at the fusion stage increased from 2.2±5.5°preoperatively to 4.9±6.5° at the last follow-up(P<0.05);the intervertebral space height also increased from 3.30±0.71° preoperatively to 4.83±0.44° at the last follow-up(P<0.05);and the cervical vertebral bow depth increased from 8.2±7.3mm preoperatively to 11.1±8.7mm at the last follow-up(P<0.05),all of which achieved certain surgical efficacy.All patients had fused surgical segments at the final follow-up,and no fusion device failure was found.There were two cases of dysphagia at the time of final follow-up,and no other complications such as esophageal or tracheal injury or cerebrospinal fluid leakage were observed.Conclusion:The ROI-C interbody fusion system is safe and effective in ACDF surgery for the treatment of elderly cervical spondylosis combined with osteoporosis.The short operation time,low intraoperative bleeding,positive effect on bone graft fusion,effective improvement of cervical curvature,restoration of intervertebral height,and reduction of the incidence of postoperative dysphagia.The early and mid-term clinical results after surgery are good.