The application of a new type of titanium mesh cage in hybrid anterior decompression and fusion technique for the treatment of continuously three-level cervical spondylotic myelopathy

Abstract

For cases with TCSM, HDF with the NTMC and TTMC can provide comparable radiological and clinical improvements. But application of the NTMC in HDF is of advantages in decreasing the subsidence incidence, losses of lordosis correction, VAS and NDI.

Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion Using Titanium Mesh Cages for Treatment of Degenerative Cervical Pathologies: A Literature Review

“…Yu et al [ 28 ] designed a new type of TMC which fully matches the adjacent endplate morphology, consisting of a hollow reticular cylinder body with 2 endcaps; however, in contrast to the previously introduced endcaps design, the superior endcap of the new TMC is curved at both ends, its inferior endcap has an oblique angle parallel to the superior endplate of the adjacent vertebral, and the ring border of both side endcaps exceeds the edge of the cylindrical body to increase the contact area between cages and endplates. To eliminate the complications associated with the traditional TMCs, Liu et al [ 23 ] designed a new type of TMC and compared the efficacy and safety with traditional TMCs in the treatment of continuous 3-level cervical spondylotic myelopathy. The new TMC has 2 unique characteristics: one is that the superior endcap is curved to fit the inferior endplate and has paralleled grooves to prevent displacement backward, and the other is that the inferior endcap is designed with an angle that tilts upward and backward to fit the superior endplate.…”

“…Narotam et al [ 25 ] and Chuang et al [ 45 ] found that after using TMCs, no patients experienced significant instability of coronal and sagittal angles, and there was minimal change in sagittal displacement, which means the stability of the cervical segment after using TMCs remains good. The symptoms before surgery, such as neck and arm pain, and other neurological deficits improved in almost all of the patients after surgery [ 14 , 23 , 24 , 45 – 47 ]. For clinical outcomes, the Japanese Orthopedic Association (JOA) scoring system is used to assess the improvement rate of relevant segmental function, and the visual analog scale (VAS) and the neck disability index (NDI) are used to compare the degree of pain before and after surgery.…”

“…For clinical outcomes, the Japanese Orthopedic Association (JOA) scoring system is used to assess the improvement rate of relevant segmental function, and the visual analog scale (VAS) and the neck disability index (NDI) are used to compare the degree of pain before and after surgery. Numerous studies have demonstrated an overall improvement in criteria scores immediately after surgery and at next follow-up, accompanied by disappearance of neurological symptoms [ 14 , 23 , 24 , 28 , 45 , 48 – 50 ]. TMC subsidence is another phenomenon frequently observed in the postoperative period.…”

“…Multiple studies have confirmed that TMC subsidence is very high (up to 90%) and leads to subsidence-related complications such as neck pain, neurological deterioration, and instrument failures [ 20 , 22 , 28 , 45 , 49 , 51 , 52 ]. In several recent studies, the new type of TMCs showed a lower rate of subsidence [ 23 , 24 , 28 ] than with traditional TMCs. Yu et al [ 28 ] compared the efficacy and safety of a new type of TMC versus the traditional TMC for single-level ACCF.…”

Plasma VDBP, 25(OH)D, and GSH levels predict surgical outcome in patients with cervical spondylotic myelopathy

“…Plain film radiography and dynamic lateral radiography of the cervical vertebra, CT scan, and MRI examination were performed. JOA scores, 40‐point scores, visual analogue scales (VAS), neck disability index (NDI), and Nurick scores were recorded.…”