Abstract：Objective To evaluate the clinical efficacy of ROI-C in the treatment of degenerative cervical spondylosis with anterior cervical discectomy and fusion.Methods A retrospective analysis from October 2013 to September 2016，104 patients underwent degenerative cervical spondylosis anterior intervertebral decompression and ROI-C interbody fusion，with 108 ROI-C implanted.There were 40 cases of nerve root type cervical spondylosis and 64 cases of cervical spondylotic myelopathy.X-rays or CT were perfomed 3 days，3 months，6 months and 12 months after operation.Neural function and pain were evaluated at the end of the follow-up with the JOA and VAS score to observe the operation time，intraoperative blood loss and complications.Intervertebral height changes and intervertebral fusion were evaluated according to the final follow-up cervical X or CT.Results 104 cases were followed up for (18.41±7.39)months (ranging from 8 to 30 months).The operation time was (51.30±2.17)min in single segment procedures and (105.53±7.14)min two segment procedures；the average operative bleeding was (43.72±2.63)mL in single segment procedures and (71.57±4.20)mL in two segment procedures.In nerve root type cervical spondylosis patients，JOA and VAS score，vertebral height improved significantly from preoperative (14.53±1.02)，(7.70±1.60) and (3.94±0.78)mm to postoperative (16.79±0.95)，(2.36±0.90) and (6.76±1.11)mm (P＝0.001) at the end of follow-up.In cervical spondylotic myelopathy patients，JOA and VAS score，vertebral height improved significantly from preoperative (10.18±1.62)，(3.53±1.46) and (3.71±0.80)mm to postoperative (14.21±1.82)，(1.44±0.79) and (6.50±1.13)mm (P＝0.001)：at the end of follow-up.The average time of fusison in single segment group was (4.20±1.53)months，(5.41±6.15)months in two segment group，and 7 months in 3 segment group.No complications were observed in all the cases such as spinal cord injury，dysphagia，hoarseness and ROI-C shifting or sinking.Conclusion In the treatment of degenerative cervical spondylosis，ACDF with ROI-C can effectively reconstruct the intervertebral height，obtaining reliable cervical intervertebral stability and fusion rate，as for shorter operative time，less bleeding，less postoperative complications and improving the neurological function and postoperative pain significantly，so ACDF using ROI-C alone in treatment of cervical spondylosis is safe，effective，and clinical effect satisfactory.
［1］Cloward RB.The anterior approach for removal of ruputured cervical disks［J］.J Neurosurg，1958，15(6)：602-617.
［2］Isu T，Kamada K，Yamauchi T，et al.New surgical technique for anterior cervical fusion；surgical technique for anterior cervical fusion utilizing autogenous bone graft from the cervical vertebrae［J］.No Shinkei Geka，1992，20(10)：1055-1061.
［3］Kim K，Isu T，Daijiro M，et al.Long-term results after cervical anterior fusion using an autologous bone graft(Williams-isu method)［J］.World Neurosurg，2014，82(1-2)：219-224.
［4］Fielding JW.Complications of anterior cervical disk removal and fusion［J］.Clin Orthop Relat Res，1992，284(284)：10-13.
［5］van Dijk M，Smit TH，Sugihara S，et al.The effect of cage stiffness on the rate of lumbar interbody fusion：an in vivo model using poly(l-lactic Acid)and titanium cages［J］.Spine(Phila Pa 1976)，2002，27(7)：682-688.
［6］Pinder EM，Sharp DJ.Cage subsidence after anterior cervical discectomy and fusion using a cage alone or combined with anterior plate fixation［J］.J Orthop Surg(Hong Kong)，2016，24(1)：97-100.
［7］Chen Y，Lu G，Wang B，et al.A comparison of anterior cervical discectomy and fusion(ACDF)using self-locking stand-alone polyetheretherketone(PEEK)cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy：a retrospective study with 2-year follow-up［J］.Eur Spine J，2016，25(7)：2255-2262.
［8］Wang JC，McDonough PW，Kanim LE，et al.Increased fusion rates with cervical Plating for three-level anterior cervical discectomy and fision［J］.Spine，200l，26(6)：64l-643.
［9］Lin CN，Wu YC，Wang NP，et al.Preliminary experience with anterior interbody titanium cage fusion for treatment of cervical disc disease［J］.Kaobsiung Med Sci，2003，19(5)：208-215.
［10］黎庆初，张忠民，尹刚辉，等.自锁式颈椎融合器在多节段脊髓型颈椎病中的应用［J］.中华外科杂志，2012，50(9)：818-822.
［11］Fraser JF，Hrtl R.Anterior approaches to fusion of the cervical spine：a meta analysis of fusion rates［J］.J Neurosurg Spine，2007，6(4)：298-303.
［12］Quinn JC，Kiely PD，Lebl DR，et al.Anterior surgical treatment of cervical spondylotic myelopathy：review article［J］.HSS J，2015，11(1)：15-25.
［13］Kaiser MG，Haid RW，Subach BR，et al.Anterior cervical plating enhances arthrodesis after discectomvy and fusion with cortical allograft［J］.Neurosurgery，2002，50(2)：229-238.
［14］Taha JM，Zuccarello M.Orion anterior cervical plate system［J］.Neurosurgery，1996，38(3)：607-609.
［15］Topuz K，Colak A，Kaya S，et al.Two-level contiguous cervical disc disease treated with peek cages packed with demineralized bone matrix：results of 3-year follow-up［J］.Eur Spine J，2009，18(2)：238-243.
［16］Miller LE，Block JE.Safety and effectiveness of bone allografts in anterior cervical discectomy and fusion surgery［J］.Spine，2011，36(24)：2045-2050.
［17］Kettler A，Wilke HJ，Dietl R，et al.Stabilizing effect of posterior lumbar interbody fusion cage befor and after cyclie lording［J］.J Neurosurg，2000，92(1 Suppl)：87-92.
［18］Moon HJ，Kim JH，Kim JH，et al.The effects of anterior cervical discectomy and fusion with stand-alone cages at two contiguous levels on cervical alignment and outcomes［J］.Acta Neurochir(Wien)，2011，153(3)：559-565.
［19］Radcliff KE，Bennett J，Stewart RJ，et al.Change in angular alignment is associated with early dysphagia after anterior cervical diskectomy and fusion［J］.J Spinal Disord Tech，2013，29(6)：248-254.
［20］Pechlivanis I，Thuring T，Brenke C，et al.Non-fusion rates in anterior cervical discectomy and implantation of empty polyetheretherke-tone cages［J］.Spine(Phila Pa 1976)，2011，36(1)：15-20.
［21］Schmieder K，Wolzik-Grossmann M，Pechlivanis I，et al.Subsidence of the wing titanium cage after anterior cervical interbody fusion：2-year follow-up study［J］.J Neurosurg Spine，2006，4(6)：447-453.
［22］Shimamoto N，Cunningham BW，Dmitriev AE，et al.Biomechanical evaluation of stand-alone interbody fusion cages in the cervical spine［J］.Spine(Phila Pa 1976)，2001，26(19)：432-436.
［23］Papadopoulos EC，Huang RC，Girardi FP，et al.Three-level anterior cmwical diseectomv and fusion with plate fixation：radiographic and clinical results［J］.Spine(Phila Pa 1 976)，2006，31(8)：897-902.
［24］Phillips FM，Lee JY，Geisler FH，et al.A prospective，randomized，controlled clinical investigation comparing PCM(R)cervical disc arthroplasty to anterior cervical discectomy and fusion：2 year results from the US IDE clinical trial［J］.Spine，2013，38(15)：907-918.
［25］Song KJ，Taghavi CE，Hsu MS，et al.Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders［J］.Eur Spine J，2010，19(10)：1677-1683.
［26］Kasimatis GB，Panagiotopoulos E，Gliatis J，et al.Complications of anterior surgery in cervical spine trauma：an overview［J］.Clin Neurol Neurosurg，2009，111(1)：18-27.
［27］Tortolani PJ，Cunningham BW，Vigna F，et al.A comparison of retraction pressure during anterior cervical plate surgery and cervical disc replacement：a cadaveric study［J］.J Spinal Disord Tech，2006，19(5)：312-317.
［28］Lee MJ，Bazaz R，Furey CG，et al.Influence of anterior cervical plate design on Dysphagia：a 2-year prospective longitudinal follow-up study［J］.J Spinal Disord Tech，2005，18(5)：406-409.
［29］Yue WM，Brodner W，Highland TR.Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating：a 5 to 11 year follow-up study［J］.Eur Spine J，2005，14(7)：677-682.
［30］Scholz M，Schnake KJ，Pingel A，et al.A new zero-profile implant for stand-alone anterior cervical interbody fusion［J］.Clin Orthop Relat Res，2011，469(3)：666-673.
［31］Scholz M，Reyes PM，Schleicher P，et al.A new stand-alone cervical anterior interbody fusion device：biomechanical comparison with established anterior cervical fixation devices［J］.Spine(Phila Pa 1976)，2009，34(2)：156-160.
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