Effect of Dome-Shaped Titanium Mesh Cages on Cervical Endplate Under Cyclic Loading: An In Vitro Biomechanics Study

Abstract

BackgroundThis study aimed to verify the anti-subsidence ability of dome-shaped titanium mesh cage (TMC) used in anterior cervical corpectomy and fusion (ACCF).Material/MethodsThirty fresh human cervical vertebrae specimens were collected and randomly harvested into 2 groups: the traditional TMC group and the dome-shaped TMC group. The bone mineral density (BMD) of the specimens was recorded. Each group was biomechanically tested in axial compression with a cyclically loading range from 60 to 300 N at 0.5Hz for 10 000 cycles. The displacement data of the 2 groups were recorded every 10 cycles.ResultsThere was no significant difference in bone mineral density between the 2 groups of cervical specimens. The traditional TMC group stabilized at 535±35 cycles while the dome-shaped TMC group stabilized at 1203±57 cycles, which showed that the rate of subsidence of the dome-shaped TMC group was significantly slower than that of the traditional TMC group (p<0.05). After reaching stability, both groups had a more gradual and sustained growth. The peak displacement during fatigue testing was −2.064±0.150mm in the traditional TMC group and −0.934±0.086mm in the dome-shaped TMC group, which showed a significant difference (p<0.05).ConclusionsThe dome-shaped TMC showed a smaller subsidence displacement and a gentler subsidence tendency following the same cyclic loading (compared to the traditional TMC). From a biomechanical point of view, the dome-shaped TMC has stronger anti-subsidence ability due to its unique structural design that closely matches the vertebral endplate.

Cervical non-fusion using biomimetic artificial disc and vertebra complex: technical innovation and biomechanics analysis

“…The mismatch between the prostheses and endplate can cause subsidence which induces fixation looseness and reoperation [ 50 , 51 ]. Previous research found that dome-shaped TMC can significantly reduce the subsidence, and matching with the endplate can also increase the maximum load by 53.8% [ 52 , 53 ]. In this study, we established that the lower endplate of the C4 had an arched shape, and thus a dome-shaped supporting structure of the upper artificial disc was designed (Fig.…”

“…Based on nIBA (Table 2 ), the oblique angle of the intermediate artificial vertebra was designed to be 10°. Previously, Lu and Wang proposed that an oblique angle could improve mechanical capacity [ 52 , 53 ].…”

Comparative Analysis of 3D-Printed Artificial Vertebral Body Versus Titanium Mesh Cage in Repairing Bone Defects Following Single-Level Anterior Cervical Corpectomy and Fusion

“…The bending strength, tensile strength, compressive strength, and elastic modulus of the n-HA/PA66 strut are similar to those of human bone, but the osteoconductivity and osseointegration characteristics of the prosthetics are still insufficient for clinical applications. Wang et al [ 8 ] conducted in vitro biomechanical studies on a dome-shaped TMC, finding it has stronger resistance to subsidence than normal TMC, but the clinical effect of the dome-shaped TMC needs to be further verified. Lu et al [ 9 ] used a new type of 3D-printed anatomy adaptive titanium mesh cage (3D-printed AA-TMC) to treat CSM and ossification of the posterior longitudinal ligament (OPLL).…”

Biomechanical effects of different approaches and titanium mesh in combined anterior cervical corpectomy decompression and fusion：a finite element study

“…In clinical practice, after partial vertebrectomy, titanium mesh is commonly used to support and fuse the vertebral body [13][14][15][16][17][18][19]. Research by the Lu team suggests that titanium mesh cages (TMC) can provide su cient biomechanical stability and have high clinical e cacy.…”