Abstract: Objective To investigate the clinical outcomes of zero-profile anchored spacer(ROI-C)for anterior cervical decompression and fusion. Methods Anterior cervical decompression and fusion were performed by ROI-C system in 25 patients with cervical spondylotic myelopathy and cervical spondylotic radiculopathy(32 intervertebral discs). The operation time, intraoperative blood loss were recorded. Visual Analogue Scale(VAS)score, Japanese Orthopaedic Society(JOA)score and intervertebral height at time points of before surgery, at 1-, 3- and 6-month of surgery, respectively were recorded. Results All the 25 patients were followed up for more than months. The operation time was(78.40±52.34)min, intraoperative blood loss was(86.00±22.73)mL. The JOA score and intervertebral height at each time point after the operation were higher than operation before, VAS scores at each time point after surgery was lower than those before surgery, the differences were statistically significant(P<0.05). There were no significant between-group differences in JOA score, VAS score and intervertebral space height at the postoperative time points(P>0.05). Conclusion ROI-C is an ideal cervical intervertebral fusion cage, with the advantages of simple operation, less trauma and fewer complications after operation. At the same time, the height of intervertebral space can be effectively restored, and the physiological curvature and stability of cervical spine can be reconstructed.