Efficacy and safety of the use of titanium mesh cages and anterior cervical plates for interbody fusion after anterior cervical corpectomy

Chuang, Hao Che; Cho, Der Yang; Chang, Ching‐Wen; Lee, Wen Yuen; Jung-Chung, Chen; Lee, Han Chung; Chen, Chun-Chung

doi:10.1016/j.surneu.2005.12.021

Cited by 31 publications

(24 citation statements)

References 28 publications

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“…ACCF with TMC is an established operative treatment for degenerative cervical pathologies and offers several advantages, including direct decompression of neural tissue, immediate stability of the anterior column, restoration and maintenance of the intervertebral disk height, enlargement of a stenotic neural foramen, and avoidance of the morbidity at the harvest site of a bone graft [20][21][22][23]. TMC subsidence after ACCF, however, the most common implant-related complication, occurs in up to 80 % of patients in the early postoperative period (\6 months) [7-11, 24, 25].…”

Section: Discussionmentioning

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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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%

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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“…Moreover, fusion assessment in the TMC is much more difficult, because the titanium mesh is not radiolucent and prevents the direct observation of bony bridging inside cage on plain radiographs [23,24]. The radiographic penetrability of the n-HA/PA66 cage is slightly lower than cortical bone.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, three-dimensional CT was used in all patients in this study to attempt to assess the graft fusion and cage integrity accurately. CT scans have been known as the surest direct radiographic examination for fusion assessment [8,24]. In fact, even if we used CT scans, the imaging interference from titanium mesh often influenced the observation of bony bridging at specific positions and affected the judgment of fusion.…”

Section: Discussionmentioning

confidence: 99%

Comparison of anterior cervical fusion by titanium mesh cage versus nano-hydroxyapatite/polyamide cage following single-level corpectomy

Yang

Chen

Liu

et al. 2013

International Orthopaedics (SICOT)

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Purpose The titanium mesh cage (TMC) is a typical metal cage device which has been widely used in cervical reconstruction for decades. Nano-hydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel biomimetic non-metal cage device growing in popularity in many medical centres in recent years. There has been no comparison of the efficacy between these two anterior reconstructing cages. The purpose of this study was to compare the radiographic and clinical outcomes of these two different devices. Methods Sixty-seven eligible patients with single-level ACCF using TMC or n-HA/PA66 cage for cervical degenerative diseases, with four-year minimum follow-up, were included in this prospective non-randomised comparative study. Their radiographic (cage subsidence, fusion status, segmental sagittal alignment [SSA]) and clinical (VAS and JOA scales) data before surgery and at each follow-up was recorded completely. Results The fusion rate of the n-HA/PA66 group was higher than TMC at one year after surgery (94 % vs. 84 %) though their finial fusion rates were similar (97 % vs. 94 %). Finial n-HA/PA66 cage subsidence was 1.5 mm with 6 % of severe subsidence over three millimetres, which was significantly lower than the respective 2.9 mm and 22 % of TMC (P <0.0001). Lastly, SSA, VAS and JOA in TMC group were worse than in the n-HA/PA66 group (P =0.235, 0.034 and 0.007, respectively). ConclusionsThe n-HA/PA66 cage is associated with earlier radiographic fusion, less subsidence and better clinical results than TMC within four years after one-level ACCF. With the added benefit of radiolucency, the n-HA/PA66 cage may be superior to TMC in anterior cervical construction.

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“…Большой популяр-ностью среди хирургов пользуются ПЦМИ, которые могут быть исполь-зованы для ПМТС различной про-тяженности, от моносегментарного до мультисегментарного. В классиче-ском варианте они должны быть плот-но заполнены измельченной костью или кортикальным аутотранспланта-том [13,28]. В некоторых клиниках продолжается использование цель-ных цилиндрических имплантатов из пористого никелида титана [3,7].…”

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“…На фоне прогресси-рования деформации позвоночника эти осложнения приводят к появле-нию болевого синдрома или нарас-танию неврологических нарушений [13,29]. Факторами риска для возник-новения вышеописанных осложнений являются остеопении (проблема несо-ответствия плотности костной ткани и материала имплантата) и избыточ-ная дистракция тел позвонков перед восстановлением межтеловой опоры [19,25].…”

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Titanium Implants in Spine Surgery: Promising Directions

Vishnevsky¹,

Казбанов²,

Batalov³

2015

Hir. pozvonoč.

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Efficacy and safety of the use of titanium mesh cages and anterior cervical plates for interbody fusion after anterior cervical corpectomy

Cited by 31 publications

References 28 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

Comparison of anterior cervical fusion by titanium mesh cage versus nano-hydroxyapatite/polyamide cage following single-level corpectomy

Titanium Implants in Spine Surgery: Promising Directions

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