Anterior cervical decompression and internal fixation is the most common treatment for cervical spondylosis at present. Low profile or zero notch internal fixation materials are constantly emerging in order to reduce the effect of titanium plate thickness on the esophagus and pharynx, and to simplify the operation procedure. The self-locking interbody fusion MC+® and ROI-C™ provides a solution of titanium plate notch effect and more simple operation methods for anterior cervical operation.OBJECTIVE:
To compare the effect on cervical stability, fusion rate and clinical efficacy by anterior cervical decompression and internal fixation using various self-locking interbody fusion MC+® or ROI-C™ to treat cervical spondylosis.METHODS:
From June to September 2013, we treated 36 cervical spondylosis patients by anterior cervical decompression and internal fixation. According to different types of intervertebral fusion device, the patients were divided into two groups: MC+® group and ROI-C™ group. Each patient underwent cervical anteroposterior and lateral radiographs, lateral flexion extension radiographs, CT scanning before operation, at 3 days, and 3 months after operation. Cervical curvature, intervertebral height, vertebral angle displacement and horizontal displacement were measured. Cervical pain visual analog scale score and Bazaz dysphagia score were evaluated.RESULTS AND CONCLUSION:
In both groups, cervical curvature and intervertebral space height showed significantly increases after operation (P < 0.05), but no significant difference in cervical curvature and intervertebral space height was detected between two groups at 3 days or 3 months after operation (P > 0.05). In MC+® group, angle displacement and horizontal displacement showed significant increases in 3 days after operation (P < 0.05), but angle displacement and horizontal displacement at 3 months after operation showed significantly decrease compared with those of before operation and 3 months after operation (P < 0.05). In ROI-C™ group, angle displacement and horizontal displacement showed a marked decline at 3 days and 3 months after operation. Angle displacement and horizontal displacement were significantly higher in MC+® group than in the ROI-C™ group at 3 days or 3 months. No significant differences in fusion rate were detected between both groups at 3 months (P > 0.05). No significant differences in cervical pain visual analog scale score and Bazaz dysphagia score were detectable between both groups (P > 0.05). These data indicated that anterior cervical decompression and internal fixation combined with MC+® or ROI-C™ cervical fusion cage for single-segment cervical spondylosis has reliable clinical therapeutic effects, and the operation is simple; uncomfortable throat pain is less. MC+® cage was relatively cheap. The combination with cervical external fixation can achieve the requirement of vertebral stability. ROI-C™ cage can achieve satisfactory postoperative immediate stability, and is a satisfactory choice for treating cervical spondylosis. In conclusion, the two kinds of locking fusion cage have their advantages and disadvantages. A suitable fusion cage should be selected according to patients' economic situation and vertebral stability requirements.