Efficacy and safety of ROI-C™ self-locking system versus cage combined with screw-plate internal fixation in the treatment of degenerative cervical disease: A meta-analysis.

BACKGROUND

This meta-analysis rigorously compares the efficacy and safety of the ROI-C™ self-locking system with that of the traditional cage combined with screw-plate (CCP) internal fixation in treating degenerative cervical disease. The goal is to enhance surgical decision-making and improve patient outcomes in managing this condition.

METHODS

In this meta-analysis, we searched the PubMed, Embase, and Cochrane Library databases from their establishment to May 2024. We proposed to include randomized controlled trials (RCTs) and non-RCTs reported ROI-C™ self-locking system and CCP internal fixation for patients with degenerative cervical spondylosis, excluding published and unpublished literature on other study types, literature with incomplete or inadequate information, animal experiments, literature reviews, and systematic studies. Data were processed using STATA 15.1 software.

RESULTS

These studies encompassed both cohort studies and 1 RCT, involving a total of 918 patients (449 in the ROI-C group and 469 in the CCP group). Meta-analysis results showed that the ROI-C™ system is associated with shorter operation time and less blood loss compared to the CCP group. The incidences of postoperative adjacent segment degeneration and dysphagia were significantly lower in the ROI-C group. However, differences in Japanese Orthopedic Association scores, neck disability index scores, cervical lordosis, fusion rate, and cage subsidence incidence were not statistically significant between the 2 groups.

CONCLUSION

The ROI-C™ self-locking system is associated with shorter operation time, reduced blood loss, and lower incidences of postoperative adjacent segment degeneration and dysphagia compared to traditional CCP fixation. Both systems, however, demonstrated similar efficacy in neurological improvement and fusion rates. These results suggest that the ROI-C™ could be a preferable alternative in certain clinical scenarios to minimize specific postoperative complications.