Skip to main content
Log in

Anterior cervical discectomy and fusion with ROI-C peek cage: cervical alignment and patient outcomes

European Spine Journal Aims and scope Submit manuscript

Cite this article



The intersomatic cage ROI-C one is a new promising system in anterior cervical discectomy with subsequent fusion.


Patients were studied prospectively. ROI-C cages were used in consecutive 32 patients. Intraoperative parameters, clinical features and dysphagia scores were recorded. Radiographs evaluated the height of intervertebral space, the cervical Cobb angle and implant positioning. Data were collected on the last day of hospital stay, at 6 weeks, at 3, 6, 12 and 24 months.


A total of 32 cages were implanted. One patient had transient dysphagia. The intervertebral height and the cervical Cobb angle were significantly improved at 24 months follow-up (P < 0.05). Compared to pre-operatively, visual analog scale pain score and neck pain and disability scale were reduced at 1-month follow-up without change during subsequent follow-up.


This is the first prospective study on ROI-C cages. Although this is a preliminary assessment, the ROI-C cage may represent an excellent alternative to other devices or simple bone graft.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5


  1. Zaveri GR, Ford M (2001) Cervical spondylosis: the role of anterior instrumentation after decompression and fusion. J Spinal Disord 14:10–16

    Article  PubMed  CAS  Google Scholar 

  2. Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8:1153–1157

    Article  PubMed  CAS  Google Scholar 

  3. Carlsson A (1983) Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 16:87–101

    Article  PubMed  CAS  Google Scholar 

  4. Goolkasian P, Wheeler A, Gretz S (2002) The neck pain and disability scale: test-retest reliability and construct validity. Clin J Pain 18:245–250

    Article  PubMed  Google Scholar 

  5. Scherer M, Blozik E, Himmel W, Laptinskaya D, Kochen MM, Herrmann-Lingen C (2008) Psychometric properties of a German version of the neck pain and disability scale. Eur Spine J 17:922–929

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine 27:2453–2458

    Article  PubMed  Google Scholar 

  7. Zdeblick TA, Ducker TB (1991) The use of freeze-dried allograft bone for anterior cervical fusions. Spine 16:726–729

    Article  PubMed  CAS  Google Scholar 

  8. Pitzen TR, Chrobok J, Stulik J, Ruffing S, Drumm J, Sova L, Kucera R, Vyskocil T, Steudel WI (2009) Implant complications, fusion, loss of lordosis, and outcome after anterior cervical plating with dynamic or rigid plates: two-year results of a multi-centric, randomized, controlled study. Spine 34:641–646

    Article  PubMed  Google Scholar 

  9. Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA (1996) Complications of iliac crest bone graft harvesting. Clin Orthop 329:300–309

    Article  PubMed  Google Scholar 

  10. Goulet JA, Senunas LE, DeSilva GL, Greenfield ML (1997) Autogenous iliac crest bone graft. Complications and functional assessment. Clin Orthop 339:76–81

    Article  PubMed  Google Scholar 

  11. Niu CC, Chen LH, Lai PL, Fu TS, Chen WJ (2005) Trapezoidal titanium cage in anterior cervical interbody fusion: a clinical experience. Chang Gung Med J 28:212–221

    PubMed  Google Scholar 

  12. van der Haven I, van Loon PJ, Bartels RH, van Susante JL (2005) Anterior cervical interbody fusion with radiolucent carbon fiber cages: clinical and radiological results. Acta Orthop Belg 71:604–609

    PubMed  Google Scholar 

  13. Cho DY, Lee WY, Sheu PC, Chen CC (2005) Cage containing a biphasic calcium phosphate ceramic (Triosite) for the treatment of cervical spondylosis. Surg Neurol 63:497–503 (discussion 503–494)

    Article  PubMed  Google Scholar 

  14. Nabhan A, Ahlhelm F, Pitzen T, Steudel WI, Jung J, Shariat K, Steimer O, Bachelier F, Pape D (2007) Disc replacement using Pro-disc C versus fusion: a prospective randomised and controlled radiographic and clinical study. Eur Spine J 16:423–430

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  15. Sasso RC, Smucker JD, Hacker RJ, Heller JG (2007) Clinical outcomes of BRYAN cervical disc arthroplasty: a prospective, randomized, controlled, multicenter trial with 24-month follow-up. J Spinal Disord Tech 20:481–491

    Article  PubMed  Google Scholar 

  16. Wang Y, Cai B, Zhang XS, Xiao SH, Wang Z, Lu N, Chai W, Zheng GQ (2008) Clinical outcomes of single level Bryan cervical disc arthroplasty: a prospective controlled study. Zhonghua Wai Ke Za Zhi 46:328–332

    PubMed  Google Scholar 

  17. Auerbach JD, Jones KJ, Fras CI, Balderston JR, Rushton SA, Chin KR (2008) The prevalence of indications and contraindications to cervical total disc replacement. Spine J 8:711–716

    Article  PubMed  Google Scholar 

  18. Riley LH 3rd, Skolasky RL, Albert TJ, Vaccaro AR, Heller JG (2005) Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study. Spine 30:2564–2569

    Article  PubMed  Google Scholar 

  19. Yue WM, Brodner W, Highland TR (2005) Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study. Eur Spine J 14:677–682

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fountas KN (2005) Anterior cervical fusion using dense cancellous allografts and dynamic plating. Neurosurgery 56:E1166 (author reply E1166)

    Google Scholar 

  21. Lee M, Bazaz R, Furey C, Yoo J (2005) Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech 18:406–409

    Article  PubMed  Google Scholar 

  22. Gore DR (2001) The arthrodesis rate in multilevel anterior cervical fusions using autogenous fibula. Spine 26:1259–1263

    Article  PubMed  CAS  Google Scholar 

  23. Resnick DK, Trost GR (2007) Use of ventral plates for cervical arthrodesis. Neurosurgery 60:S112–S117

    Article  PubMed  Google Scholar 

  24. Shin DA, Yi S, Yoon do H, Kim KN, Shin HC (2009) Artificial disc replacement combined with fusion versus two-level fusion in cervical two-level disc disease. Spine 34:1153–1159 (discussion 1160-1151)

    Article  PubMed  Google Scholar 

  25. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Jt Surg 81:519–528

    CAS  Google Scholar 

  26. Kim SJ, Kim SD (2014) Anterior cervical discectomy and fusion using a double cylindrical cage versus an anterior cervical plating system with Iliac crest autografts for the treatment of cervical degenerative disc disease. J Korean Neurosurg Soc 55:12–17. doi:10.3340/jkns.2014.55.1.12

    Article  PubMed  PubMed Central  Google Scholar 

Download references


The study, in part, has been supported by the Academic funds (ex 60 % of the first author).

Conflict of interest

The authors report no declarations of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Giovanni Grasso.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grasso, G., Giambartino, F., Tomasello, G. et al. Anterior cervical discectomy and fusion with ROI-C peek cage: cervical alignment and patient outcomes. Eur Spine J 23 (Suppl 6), 650–657 (2014).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: