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

Abstract

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.

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

“…Moreover, the holes in the n-HA/PA66 cage wall may enable blood circulation between the implant bed and the autograft within the cage, which would aid in the growth of the bone graft. Previous studies have reported that subsidence occurs in up to 80% of patients during the early postoperative period prior to bony fusion [36]. In the present study, similar results were observed in all four groups, with the majority of height loss in the fused segment occurring during the 1 st postoperative year and heights remaining almost identical to these levels at the final follow-up.…”

Single-Level Anterior Cervical Corpectomy and Fusion Using a New 3D-Printed Anatomy-Adaptive Titanium Mesh Cage for Treatment of Cervical Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament: A Retrospective Case Series Study

“…Regarding the structures of both ends, our AA-TMC is similar to the redesigned TMC that Yu et al presented previously [18]. However, in the horizontal plane, the 2 TMCs are quite different.…”

Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

“…However, the sharp footprint of the titanium mesh that led to the small contact surface between the strut and endplate was thought to be the main cause of subsidence1537. A previous study reported that broadening the contact surface between the titanium mesh and the adjacent endplate could effectively decrease the incidence of subsidence38. In the present study, the n-HA/PA strut was designed with a wide annular rim (nearly three millimeters) to eliminate the risk of subsidence.…”