Anterior cervical stabilization using a semi-constrained cervical plate and titanium mesh cage for single level corpectomy

Lee, Sun-Ho; Sung, Joo-Kyung

doi:10.1016/j.jocn.2007.09.019

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…Although the clinical relevance of TMC subsidence remains controversial, theoretically, the acquired advantages of a TMC scaffold could be offset by subsidence due to the loss of intervertebral height, which can lead to buckling of the cervical yellow ligament, foraminal stenosis, and consequent re-compression of spinal cord and nerve roots. The reported causes of TMC subsidence have included increased patient age and osteopenia, progressive resection of the endplate, the sharp edge of the cage, the removal of the PLL, intervertebral overdistraction, or improper trimming of the cage [12][13][14][15][16]. Several technical measures have also been proposed to reduce or avoid postoperative TMC subsidence, such as avoiding the use of TMC in patients with osteoporosis, appropriate removal of the endplate, avoiding excessive distraction, the use of titanium mesh endcaps, or additional posterior fusion and instrumentation [9,26].…”

Section: Discussionmentioning

confidence: 99%

“…Although a variety of factors such as sex, age, resection of the posterior longitudinal ligament, type of plate and endplate preparation, and bone mineral density have already been associated with TMC subsidence in the literature [12][13][14][15][16], the differences in the orientation of the contact face of the TMC with the vertebral endplates may be important in preventing TMC subsidence [9]. For this reason, we designed a new type TMC which fully matches the vertebral endplate morphology and evaluated this new TMC in 28 patients.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion

Miao

Liao

et al. 2013

Eur Spine J

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Study design A retrospective review of prospectively collected data in an academic institution. Objective To evaluate the safety and efficacy of a new type of titanium mesh cage (TMC) in single-level, anterior cervical corpectomy and fusion (ACCF). Methods Fifty-eight patients consecutive with cervical spondylotic myelopathy (CSM) from cervical degenerative spondylosis and isolated ossification of the posterior longitudinal ligament were treated with a single-level ACCF using either a new type of TMC (28 patients, group A) or the traditional TMC (30 patients, group B). We evaluated the patients for TMC subsidence, cervical lordosis (C2-C7 Cobb and Cobb of fused segments) and fusion status for a minimum of 30 months postoperatively based on spine radiographs. In addition, neurologic outcomes were evaluated using the Japanese Orthopedic Association (JOA) scores. Neck pain was evaluated using a 10-point visual analog scale (VAS). Results The loss of height of the fused segments was less for group A than for group B (0.8 ± 0.3 vs. 2.8 ± 0.4 mm) (p \ 0.01); also, there was a lower rate of severe subsidence (C3 mm) in group A (4 %, 1/28) than in group B (17 %, 5/30) (p \ 0.01). There were no differences in the C2-C7 Cobb and Cobb of fused segments between the groups preoperatively or at final follow-up (p [ 0.05), but the Cobb of fused segments immediately postoperative were significantly less for group B than for group A (p \ 0.01). All patients, however, had successful fusion (100 %, each). Both groups had marked improvement in the JOA score after operation (p \ 0.01), with no significant differences in the JOA recovery ratio (p [ 0.05). The postoperative VAS neck pain scores for group A were significantly less than that for group B (p \ 0.05); severe subsidence was correlated with neck pain. Conclusions The new type of TMC provides comparable clinical results and fusion rates with the traditional TMC for patients undergoing single-level corpectomy. The new design TMC decreases postoperative subsidence (compared to the traditional TMC); the unique design of the new type of TMC matches the vertebral endplate morphology which appears to decrease the severity of subsidencerelated neck pain in follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion

Miao

Liao

et al. 2013

Eur Spine J

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“…For bone fusion, most studies have shown that almost all patients using TMCs achieved solid bone fusion at their final follow-up [ 14 , 20 , 23 – 25 , 28 , 45 , 51 , 54 – 56 ]. Furthermore, the mean time to achieve solid fusion was 5~7 months [ 20 , 50 , 57 , 58 ].…”

Section: The Radiological and Clinical Assessment Of Tmcsmentioning

confidence: 99%

“…Due to the potential donor-site complications of autografts [ 9 , 10 ] and low bony fusion rate and graft collapse of allografts [ 11 ], the alternative devices such as nano-hydroxyapatite/polyamide cages, PEEK cages, and TMCs were introduced for anterior cervical reconstruction. Many previous studies have reported on the efficacy and safety of traditional TMCs used in treating degenerative cervical diseases [ 45 , 47 , 53 , 54 , 57 , 66 ]. Although it avoids the donor-site morbidities and achieves a solid bony fusion, complications such as TMC subsidence still occur at follow-up [ 20 , 22 , 66 ].…”

Section: Future Directionsmentioning

confidence: 99%

Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion Using Titanium Mesh Cages for Treatment of Degenerative Cervical Pathologies: A Literature Review

et al. 2018

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Anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) are 2 effective and safe surgical treatments of degenerative cervical pathologies and are associated with a high percentage of excellent clinical outcomes when a graft or device must be used during the surgery, such as an allograft, autograft, nano-hydroxyapatite/polyamide cages, poly-ether-ether-ketone (PEEK) cages, and titanium mesh cages (TMCs). Although TMCs have been used in cervical surgeries for almost 2 decades, no specific reviews have been performed introducing the state of this material. Thus, in the present review, we discuss the status of using TMCs in anterior cervical surgeries.Studies that tested the usage of TMCs in treating degenerative cervical pathologies were included in this review. The development and progress of TMCs, the biomechanical analysis of TMCs, the radiological and clinical assessment of TMCs, the advantages and disadvantages of using TMCs, and their prospects for future applications as a device of ACCF and ACDF in treating degenerative cervical pathologies are discussed.Studies included in this review showed that TMCs can provide sufficient biomechanical stability. Furthermore, the TMCs used in anterior cervical fusion avoid the donor-site morbidity and achieve a solid bony fusion. However, there are some shortcomings. The structural characteristics and the design of TMCs cause the TMC subsidence rate to remain high, thus resulting in multiple related complications.We believe that due to the virtues of TMCs, they are worthy of application and promotion. However, the structure of TMCs should be further optimized to reduce the TMC subsidence rate and subsidence-related complications, ultimately achieving excellent clinical results.

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“…Allografts can be used to avoid the morbidity associated with autograft harvest, but this technique decreases the rate of arthrodesis and increases the rate of graft collapse [13]. Titanium mesh cages (TMCs) filled with local cancellous bone autografts have been used for decades for cervical reconstruction after corpectomy [9], [14], with advantages including few donor-site complications, early biomechanical stabilization, a short operation duration and high fusion rates (range: 97%–100%); however, the inevitable complication of subsidence and other disadvantages, including stress shielding and radiopacity also occur [15], [16], [17], [18], [19]. The nano-hydroxyapatite/polyamide66 cage (nano-HA/PA66 cage) is a hollow cylinder manufactured of the n-HA/PA66 composite (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Anterior Cervical Reconstruction with Titanium Mesh Cages versus Nano-Hydroxyapatite/Polyamide66 Cages after 1- or 2-Level Corpectomy for Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 117 Patients

et al. 2014

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ObjectiveTo retrospectively compare the efficacy of the titanium mesh cage (TMC) and the nano-hydroxyapatite/polyamide66 cage (n-HA/PA66 cage) for 1- or 2-level anterior cervical corpectomy and fusion (ACCF) to treat multilevel cervical spondylotic myelopathy (MCSM).MethodsA total of 117 consecutive patients with MCSM who underwent 1- or 2-level ACCF using a TMC or an n-HA/PA66 cage were studied retrospectively at a mean follow-up of 45.28±12.83 months. The patients were divided into four groups according to the level of corpectomy (1- or 2-level corpectomy) and cage type used (TMC or n-HA/PA66 cage). Clinical and radiological parameters were used to evaluate outcomes.ResultsAt the one-year follow-up, the fusion rate in the n-HA/PA66 group was higher, albeit non-significantly, than that in the TMC group for both 1- and 2-level ACCF, but the fusion rates of the procedures were almost equal at the final follow-up. The incidence of cage subsidence at the final follow-up was significantly higher in the TMC group than in the n-HA/PA66 group for the 1-level ACCF (24% vs. 4%, p = 0.01), and the difference was greater for the 2-level ACCF between the TMC group and the n-HA/PA66 group (38% vs. 5%, p = 0.01). Meanwhile, a much greater loss of fused height was observed in the TMC group compared with the n-HA/PA66 group for both the 1- and 2-level ACCF. All four groups demonstrated increases in C2-C7 Cobb angle and JOA scores and decreases in VAS at the final follow-up compared with preoperative values.ConclusionThe lower incidence of cage subsidence, better maintenance of the height of the fused segment and similar excellent bony fusion indicate that the n-HA/PA66 cage may be a superior alternative to the TMC for cervical reconstruction after cervical corpectomy, in particular for 2-level ACCF.

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Anterior cervical stabilization using a semi-constrained cervical plate and titanium mesh cage for single level corpectomy

Cited by 13 publications

References 27 publications

Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion

Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion

Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion Using Titanium Mesh Cages for Treatment of Degenerative Cervical Pathologies: A Literature Review

Evaluation of Anterior Cervical Reconstruction with Titanium Mesh Cages versus Nano-Hydroxyapatite/Polyamide66 Cages after 1- or 2-Level Corpectomy for Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 117 Patients

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