Cobalt-chrome and titanium alloy rods provide similar coronal and sagittal correction in adolescent idiopathic scoliosis

Sabah, Yann; Clément, Jean-Luc; Solla, Federico; Rosello, Olivier; Rampal, Virginie

doi:10.1016/j.otsr.2018.07.018

Cited by 26 publications

(33 citation statements)

References 28 publications

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“…Studies were conducted in different countries across continents that increase the external validity of the study. Four studies were done in USA [ 21 , 23 – 25 ], two studies in France [ 12 , 16 ], two studies in South Korea [ 17 , 18 ], two studies in Japan [ 19 , 22 ], and one study in Malaysia [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…These studies reported the different outcomes of interest concerning our study questions. Four studies compared correction rate [ 12 , 16 , 19 , 20 ]; five studies compared rod fracture [ 17 – 19 , 24 , 25 ]; three studies compared thoracic kyphosis [ 12 , 16 , 20 ], proximal junctional kyphosis [ 12 , 17 , 18 ], and fatigue life [ 21 – 23 ] each; two studies compared lumbar lordosis [ 12 , 16 ] and bending stiffness [ 22 , 23 ] each. Studies comparing similar outcomes were analyzed together in the same forest plot.…”

Section: Resultsmentioning

confidence: 99%

“…Figure 2 elucidates four [ 12 , 16 , 19 , 20 ] of the eleven included studies that compared correction rate outcomes in percentage between cobalt chromium rods versus titanium rods. The overall mean difference between the two implants was −0.24, 95% CI (−3.32, 2.84) favouring cobalt chromium rods, but the difference did not reach statistical significance with p value = 0.88 (i.e.…”

Section: Resultsmentioning

confidence: 99%

“…Cobalt chromium (CoCr) and titanium alloy TA6V (Ti) are mostly used rods as they exhibit favorable biomechanical properties such as resistance to corrosion and compatibility with magnetic resonance imaging (MRI) [ 11 ]. However, the titanium has greater elasticity, whereas cobalt chromium has greater stiffness [ 12 ]. Contouring of rods plays a significant role in overall postoperative correction outcomes as it can diminish their fatigue strength and increases the risk of rod fracture after implantation [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis

Shega

Zhang

Manini

et al. 2020

Advances in Orthopedics

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Background. Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. The selection of a proper rod material is crucial due to their specific mechanical properties that influence the surgical outcome. The purpose of this study is to compare the effectiveness of cobalt chromium rods versus titanium rods for the treatment of spinal deformity by a systematic review and meta-analysis. Methods. PubMed, EMBASE, and the Cochrane library were searched for observational and biomechanical studies comparing cobalt chromium and titanium rods in terms of correction rate, thoracic kyphosis, lumbar lordosis, incidence of rod fracture, fatigue life of contoured rod, bending stiffness of rods, and occurrence of proximal junctional kyphosis. The demographic data and mean values of outcomes of interest were extracted from each group and compared by their mean difference as an overall outcome measure. The Review Manager software (RevMan 5.3) was utilized at a 95% significance level. Results. Eleven eligible studies with 641 participants for 7 observational studies and 35 samples for 4 biomechanical studies were identified. There were no significant differences between cobalt chromium and titanium rods in the correction rate of spinal deformity. Postoperative thoracic kyphosis was well restored in the cobalt chromium group with statistical significance (p value = 0.009). The incidence of rod fracture was high in titanium rods compared to cobalt chromium rods with significant difference (p value = 0.0001). Proximal junctional kyphosis occurs more in the cobalt chromium group with a significant difference (p value = 0.0009). No statistical significance between two materials in terms of lumbar lordosis, fatigue of life, and bending stiffness of rods. Conclusion. The cobalt chromium rod is better than titanium rod for effective correction of spinal deformity and postoperative stability of the spine. However, the use of cobalt chromium rods is associated with increased risk of proximal junctional kyphosis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis

Shega

Zhang

Manini

et al. 2020

Advances in Orthopedics

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“…The durability of the CoCr-rod compared to the Ti-rod is not different according to recent studies. [50][51][52] In the clinical situation of a cervical deformity with need for reduc- Fig. 9.…”

Section: B C D E F G a Imentioning

confidence: 99%

The Effect of Rod Pattern, Outrigger, and Multiple Screw-Rod Constructs for Surgical Stabilization of the 3-Column Destabilized Cervical Spine - A Biomechanical Analysis and Introduction of a Novel Technique

et al. 2020

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Anterior-only reconstructions for cervical multilevel corpectomies are prone to fail under continuous mechanical loading. This study sought to define the mechanical characteristics of different constructs in reducing a range of motion (ROM) of the 3-column destabilized cervical spine, including posterior cobalt-chromium (CoCr)-rods, outrigger-rods (OGR), and a novel triple rod construct using lamina screws (6S3R). The clinical implications of biomechanical findings are discussed in depth from the perspective of the challenges surgeons face cervical deformity correction. Methods: Three-column deficient cervical spinal models were produced based on reconstructed computed tomography scans. The corpectomy defect between C3 and C7 end-level vertebrae was restored with anterior titanium (Ti) mesh-cage. The ROM was evaluated in a customized 6-degree of freedom spine tester. Tests were performed with different rod materials (Ti vs. CoCr), varying diameter rods (3.5 mm vs. 4.0 mm), with and without anterior plating, and using different construct patterns: bilateral rod fixation (standard-group), OGRgroup, and 6S3R-Group. Construct stability was expressed in changes and differences of ROM (°). Results: The largest reduction of ROM was noticed in the 6S3R-group compared to the standard-and the OGR-group. All differences observed were emphasized with an increasing number of corpectomy levels and if anterior plating was not added. For all simulated 1-, 2-, and 3-level corpectomy constructs, the OGR-group revealed decreased ROM for all motion directions compared to the standard-group. An increase of construct stiffness was also recorded for increased rod diameter (4.0 mm) and stiffer rod material (CoCr), though these effects lacked behind the more advanced construct pattern. Conclusion: A novel reconstructive technique, the 6S3R-construct, was shown to outperform all other constructs and might resemble a new standard of reference for advanced posterior fixation.

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Prevention of surgical site infections in pediatric spines: a single-center experience

et al. 2021

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Cobalt-chrome and titanium alloy rods provide similar coronal and sagittal correction in adolescent idiopathic scoliosis

Cited by 26 publications

References 28 publications

Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis

Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis

The Effect of Rod Pattern, Outrigger, and Multiple Screw-Rod Constructs for Surgical Stabilization of the 3-Column Destabilized Cervical Spine - A Biomechanical Analysis and Introduction of a Novel Technique

Prevention of surgical site infections in pediatric spines: a single-center experience

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