The ROI-C zero-profile anchored spacer for anterior cervical discectomy and fusion: biomechanical profile and clinical outcomes

Michael N Bucci, Dennis Oh, R Scott Cowan, Reginald J Davis, Robert J Jackson, Dwight S Tyndall, Daniel Nehls, Michael N Bucci, Dennis Oh, R Scott Cowan, Reginald J Davis, Robert J Jackson, Dwight S Tyndall, Daniel Nehls

Abstract

Introduction: Anterior cervical discectomy and fusion (ACDF) has been the gold standard for treating cervical degenerative disc disease (cDDD). The use of anterior plates in ACDF poses an increased risk of complications such as screw or plate dislodgement, soft tissue injury, esophagus perforation, and dysphagia. The ROI-C™ implant system consists of a zero-profile interbody fusion cage with self-locking plates designed for stand-alone fusion without external plates or screws.

Objective: The purpose of this report is to describe the ROI-C™ implant system with VerteBRIDGE™ anchor plates, including indications for use, surgical technique, preclinical testing, and clinical study results. The objectives of the clinical study were to assess fusion status, incidence of dysphagia and other device-related complications, and patient reported outcomes.

Methods: This was a retrospective, multicenter cohort study of 110 patients who underwent ACDF with ROI-C at seven study centers. Patient charts and radiographs were reviewed for any complications or device malfunction. The final follow-up was conducted prospectively and included collection of neck disability index, and visual analog scale (VAS) neck and arm pain scores.

Results: The mean operation time was 73 minutes, and mean blood loss was 25 mL (range 0-75 mL). Mean follow-up was 20.7 months (range 9.5-42.2). Dysphagia was reported in two patients (1.8%), and 99.1% of patients achieved fusion. One patient had radiographically confirmed pseudarthrosis at 12 months that was asymptomatic and did not require surgery. One patient had subsequent surgery owing to adjacent level degeneration. The mean neck disability index, VAS neck pain, and VAS right and left arm pain scores at final follow-up were 19, 26.5, 12.5, and 15.3, respectively.

Conclusion: The ROI-C interbody cage with VerteBRIDGE anchor plates achieved a high rate of fusion, with a low incidence of dysphagia. These patients had similar or better outcomes compared to ACDF with anterior plating reported in peer-reviewed literature.

Keywords: ACDF; ROI-C; cervical disc degeneration; stand-alone cage; zero-profile spacer.

Conflict of interest statement

Disclosure This study was supported by LDR Spine USA, Inc. (now Zimmer Biomet). Each of the authors was an investigator in the ROI-C retrospective study and received research support during the study. MNB and RJJ have served as consultants for LDR and Zimmer Biomet. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
The ROI-C cervical cage with VerteBRIDGE plating technology. Notes: (A) Lateral view; (B) Anterior view; (C) Superior view.
Figure 2
Figure 2
Range of motion of ROI-C with VerteBRIDGE anchor plates, Polyetheretherketone (PEEK) cage with anterior plating, and PEEK cage with screws. Notes: Range of motion is expressed as a percentage of the Intact specimen ROM. Data for PEEK Cage obtained from Freeman et al. Abbreviations: ROM, range of motion; w/, with; w/2, with 2
Figure 3
Figure 3
Postoperative radiographs of the ROI-C with VerteBRIDGE anchor plates at the C4–C5 level. Notes: (A) anterior–posterior view; (B) lateral view.

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