Eleven-Year Follow-Up of Two Cohorts of Patients Comparing Stand-Alone Porous Tantalum Cage Versus Autologous Bone Graft and Plating in Anterior Cervical Fusions

Fernández-Fairén, Mariano; Alvarado, Enrique; Torres, Ana

doi:10.1016/j.wneu.2018.09.160

Cited by 24 publications

(22 citation statements)

References 73 publications

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“…We could not identify any differences in fusion-, complication rates, loss of reduction or PROM between the usage of an ICBG or a cage. This is in line with the majority of recent studies that report satisfactory radiological and clinical outcomes independent of the usage of a cage or an ICBG [20,21].…”

Section: Discussionsupporting

confidence: 91%

Does Dynamic Anterior Plate Fixation Provide Adequate Stability for Traumatic Subaxial Cervical Spine Fractures at Mid-Term Follow-Up?

Lang

Fiedler

Alt

et al. 2021

JCM

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Background: It remains questionable if the treatment of cervical fractures with dynamic plates in trauma surgery provides adequate stability for unstable fractures with disco-ligamentous injuries. The primary goal of this study was to assess the radiological and mid-term patient-reported outcome of traumatic subaxial cervical fractures treated with different plate systems. Patients and Methods: Patients, treated with anterior cervical discectomy and fusion (ACDF) between 2001 and 2015, using either a dynamic plate (DP: Mambo™, Ulrich, Germany) or a rigid locking plate (RP: CSLP™, Depuy Synthes, USA), were identified. For radiological evaluation, the sagittal alignment, the sagittal anterior translation and the bony consolidation were evaluated. After at least two years, the patient-reported outcome measures (PROM) were evaluated using the German Short-Form 36 (SF-36), Neck Disability Index (NDI) and the EuroQol in 5 Dimensions (EQ-5D) scores. Results: 33 patients met the inclusion criteria (DP: 13; RP:20). Twenty-six patients suffered from AO Type B or C fractures. Both the sagittal alignment and the sagittal translation could be sufficiently improved in both groups (p ≥ 0.05). No significant loss of reduction could be observed at the follow-up in both groups (p ≥ 0.05). Bony consolidation could be observed in 30 patients (DP: 12/13 (92%); RP: 18/20 (90%); (p ≥ 0.05)). In 20 patients, PROMs could be evaluated (follow-up: 71.2 ± 25.5 months). The whole cohort showed satisfactory PROM results (EQ-5D: 72.0 ± 4.9; SF-36 PCS: 41.9 ± 16.2, MCS: 45.4 ± 14.9; NDI: 11.0 ± 9.1). without significant differences between the DP and RP group (p ≥ 0.05) Conclusion: The dynamic plate concept provides enough stability without a difference in fusion rates in comparison to rigid locking plates in a population that mostly suffered fragile fractures.

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Section: Discussionsupporting

confidence: 91%

Does Dynamic Anterior Plate Fixation Provide Adequate Stability for Traumatic Subaxial Cervical Spine Fractures at Mid-Term Follow-Up?

Lang

Fiedler

Alt

et al. 2021

JCM

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“…Anterior cervical discectomy and fusion (ACDF) procedures with anterior plate fixation have resulted in superior surgical outcomes, including increased rates of fusion and reduced rates of subsidence [6]. Midterm follow-up of the clinical and radiological results achieved by tantalum intervertebral fusion cages for single-level ACDF have shown that the cages remain in good condition for up to 11 years postoperatively, and similar results with the use of autologous bone grafts and plating were also reported [7]. The use of plates and fusion cages with screws can promote fusion, but no clinically significant differences have been shown [8].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of Optimal Shapes for the Cervical Intervertebral Fusion Cage for C5–C6 Cervical Fusion Using the Anterior Cervical Plate and Cage (ACPC) Fixation System: A Finite Element Analysis

2019

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BackgroundThe fifth and sixth cervical vertebrae (C5–C6) represent the high-risk segment requiring surgical correction in cervical spondylosis. Anterior cervical discectomy and fusion (ACDF) of C5–C6 includes an intervertebral fusion cage to maintain foraminal height and is combined with anterior plate fixation. The shape of the intervertebral cage can affect the postoperative outcome, including the rates of fusion, subsidence, and neck pain. This study aimed to use finite element (FE) parametric analysis to compare biomechanical properties of changes in intervertebral cage shape for C5–C6 cervical fusion using the anterior cervical plate and cage (ACPC) fixation system.Material/MethodsFive shapes were designed for cervical intervertebral cages, square, oval, kidney-shaped, clover-shaped, and 12-leaf-shaped. The performance was evaluated following implantation into the validated normal C5–C6 FE model using simulation with five physiological conditions. The indicators included the maximum von Mises stress of the endplates, the fusion cages, and the cervical vertebrae. The postoperative subsidence-resistance properties were determined, including the interior stress responses of the intervertebral cages and the surrounding tissues. The fusion-promoting properties were evaluated by the interior stress responses of the bone grafts.ResultsThe optimal shape of the cervical intervertebral cage was the 12-leaf-shape for postoperative subsidence resistance. The kidney shape for the cervical intervertebral cage was optimal for postoperative fusion.ConclusionsFE analysis identified the optimal cervical intervertebral cage design for ACPC fixation of C5–C6. This method may be useful for future developments in the design of spinal implants.

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“…Compared with traditional autologous iliac bone graft combined with anterior plating, the porous Ta cage insertion group showed an equivalent fusion rate (89% vs. 85%) and post-surgery stability at the end point of a 2-year follow-up, but additional fixation and graft harvesting-related injuries no longer occurred [ 134 ]. After 11 years of follow-up, the clinical and radiological results of patients who had received single porous Ta cage insertion for interbody fusion remained satisfactory despite the subsidence of implants, presented within 2–3 mm, occurring without significant complication in 12 patients [ 135 ]. Furthermore, several observational studies had also affirmed the efficacy of porous Ta in terms of interbody fusion rate, low complication rate and improved short or long term post-surgery evaluation scores including the SF-36, neck disability index (NDI) and visual analog score (VAS) [ 136 , 137 , 138 ].…”

Section: Clinical Application Of Porous Ta In Orthopedics and Dentistrymentioning

confidence: 99%

The Clinical Application of Porous Tantalum and Its New Development for Bone Tissue Engineering

2021

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Porous tantalum (Ta) is a promising biomaterial and has been applied in orthopedics and dentistry for nearly two decades. The high porosity and interconnected pore structure of porous Ta promise fine bone ingrowth and new bone formation within the inner space, which further guarantee rapid osteointegration and bone–implant stability in the long term. Porous Ta has high wettability and surface energy that can facilitate adherence, proliferation and mineralization of osteoblasts. Meanwhile, the low elastic modulus and high friction coefficient of porous Ta allow it to effectively avoid the stress shield effect, minimize marginal bone loss and ensure primary stability. Accordingly, the satisfactory clinical application of porous Ta-based implants or prostheses is mainly derived from its excellent biological and mechanical properties. With the advent of additive manufacturing, personalized porous Ta-based implants or prostheses have shown their clinical value in the treatment of individual patients who need specially designed implants or prosthesis. In addition, many modification methods have been introduced to enhance the bioactivity and antibacterial property of porous Ta with promising in vitro and in vivo research results. In any case, choosing suitable patients is of great importance to guarantee surgical success after porous Ta insertion.

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Eleven-Year Follow-Up of Two Cohorts of Patients Comparing Stand-Alone Porous Tantalum Cage Versus Autologous Bone Graft and Plating in Anterior Cervical Fusions

Cited by 24 publications

References 73 publications

Does Dynamic Anterior Plate Fixation Provide Adequate Stability for Traumatic Subaxial Cervical Spine Fractures at Mid-Term Follow-Up?

Does Dynamic Anterior Plate Fixation Provide Adequate Stability for Traumatic Subaxial Cervical Spine Fractures at Mid-Term Follow-Up?

Biomechanical Comparison of Optimal Shapes for the Cervical Intervertebral Fusion Cage for C5–C6 Cervical Fusion Using the Anterior Cervical Plate and Cage (ACPC) Fixation System: A Finite Element Analysis

The Clinical Application of Porous Tantalum and Its New Development for Bone Tissue Engineering

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