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Published in: European Spine Journal 12/2013

01-12-2013 | Original Article

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

Authors: Yu Fengbin, Miao Jinhao, Liao Xinyuan, Wang Xinwei, Chen Yu, Chen Deyu

Published in: European Spine Journal | Issue 12/2013

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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 (≥3 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 subsidence-related neck pain in follow-up.
Literature
1.
go back to reference Chagas H, Domingues F, Aversa A et al (2005) Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion. Surg Neurol 64(Suppl 1):30–35CrossRef Chagas H, Domingues F, Aversa A et al (2005) Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion. Surg Neurol 64(Suppl 1):30–35CrossRef
2.
go back to reference Cheng NS, Lau PY, Sun LK et al (2005) Fusion rate of anterior cervical plating after corpectomy. J Orthop Surg (Hong Kong) 13:223–227 Cheng NS, Lau PY, Sun LK et al (2005) Fusion rate of anterior cervical plating after corpectomy. J Orthop Surg (Hong Kong) 13:223–227
3.
go back to reference Liu JK, Apfelbaum RI, Schmidt MH (2004) Surgical management of cervical spinal metastasis: anterior reconstruction and stabilization techniques. Neurosurg Clin N Am 15:413–424PubMedCrossRef Liu JK, Apfelbaum RI, Schmidt MH (2004) Surgical management of cervical spinal metastasis: anterior reconstruction and stabilization techniques. Neurosurg Clin N Am 15:413–424PubMedCrossRef
4.
go back to reference Chun HJ, Oh SH, Yi HJ et al (2009) Efficacy and durability of the titanium mesh cage spacer combined with transarticular screw fixation for atlantoaxial instability in rheumatoid arthritis patients. Spine 34:2384–2388PubMedCrossRef Chun HJ, Oh SH, Yi HJ et al (2009) Efficacy and durability of the titanium mesh cage spacer combined with transarticular screw fixation for atlantoaxial instability in rheumatoid arthritis patients. Spine 34:2384–2388PubMedCrossRef
5.
go back to reference Sevki K, Mehmet T, Ufuk T et al (2004) Results of surgical treatment for degenerative cervical myelopathy: anterior cervical corpectomy and stabilization. Spine 29:2493–2500PubMedCrossRef Sevki K, Mehmet T, Ufuk T et al (2004) Results of surgical treatment for degenerative cervical myelopathy: anterior cervical corpectomy and stabilization. Spine 29:2493–2500PubMedCrossRef
6.
go back to reference Epstein NE (2001) Reoperation rates for acute graft extrusion and pseudarthrosis after one-level anterior corpectomy and fusion with and without plate instrumentation: etiology and corrective management. Surg Neurol 56:73–780PubMedCrossRef Epstein NE (2001) Reoperation rates for acute graft extrusion and pseudarthrosis after one-level anterior corpectomy and fusion with and without plate instrumentation: etiology and corrective management. Surg Neurol 56:73–780PubMedCrossRef
7.
go back to reference Nakase H, Park YS, Kimura H et al (2006) Complications and long-term follow-up results in titanium mesh cage reconstruction after cervical corpectomy. J Spinal Disord Tech 19:353–357PubMedCrossRef Nakase H, Park YS, Kimura H et al (2006) Complications and long-term follow-up results in titanium mesh cage reconstruction after cervical corpectomy. J Spinal Disord Tech 19:353–357PubMedCrossRef
8.
go back to reference Das K, Couldwell WT, Sava G et al (2001) Use of cylindrical titanium mesh and locking plates in anterior cervical fusion. Technical note. J Neurosurg 94:174–178PubMed Das K, Couldwell WT, Sava G et al (2001) Use of cylindrical titanium mesh and locking plates in anterior cervical fusion. Technical note. J Neurosurg 94:174–178PubMed
9.
go back to reference Chen Y, Chen D, Guo Y et al (2008) Subsidence of titanium mesh cage: a study based on 300 cases. J Spinal Disord 21:489–492 Chen Y, Chen D, Guo Y et al (2008) Subsidence of titanium mesh cage: a study based on 300 cases. J Spinal Disord 21:489–492
10.
go back to reference Kanayama M, Hashimoto T, Shigenobu K et al (2003) Pitfalls of anterior cervical fusion using titanium mesh and local autograft. J Spinal Disord Tech 16:513–518PubMedCrossRef Kanayama M, Hashimoto T, Shigenobu K et al (2003) Pitfalls of anterior cervical fusion using titanium mesh and local autograft. J Spinal Disord Tech 16:513–518PubMedCrossRef
11.
go back to reference Daubs MD (2005) Early failures following cervical corpectomy reconstruction with titanium mesh cages and anterior plating. Spine 30:1402–1406PubMedCrossRef Daubs MD (2005) Early failures following cervical corpectomy reconstruction with titanium mesh cages and anterior plating. Spine 30:1402–1406PubMedCrossRef
12.
go back to reference Yan D, Wang Z, Deng S et al (2011) Anterior corpectomy and reconstruction with titanium mesh cage and dynamic cervical plate forcervical spondylotic myelopathy in elderly osteoporosis patients. Arch Orthop Trauma Surg 131:1369–1374PubMedCrossRef Yan D, Wang Z, Deng S et al (2011) Anterior corpectomy and reconstruction with titanium mesh cage and dynamic cervical plate forcervical spondylotic myelopathy in elderly osteoporosis patients. Arch Orthop Trauma Surg 131:1369–1374PubMedCrossRef
13.
go back to reference Hee HT, Madj ME, Holt RT et al (2003) Complications of multilevel cervical corpectomies and reconstruction with titanium cages and anterior plating. J Spinal Disord 6:1–8 Hee HT, Madj ME, Holt RT et al (2003) Complications of multilevel cervical corpectomies and reconstruction with titanium cages and anterior plating. J Spinal Disord 6:1–8
14.
go back to reference Lim TH, Kwon H, Jeon CH et al (2001) Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion. Spine 26:951–956PubMedCrossRef Lim TH, Kwon H, Jeon CH et al (2001) Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion. Spine 26:951–956PubMedCrossRef
15.
go back to reference Lee SH, Sung JK (2008) Anterior cervical stabilization using a semi-constrained cervical plate and titanium mesh cage for single level corpectomy. Journal of Clinical Neuroscience 15:1227–1234PubMedCrossRef Lee SH, Sung JK (2008) Anterior cervical stabilization using a semi-constrained cervical plate and titanium mesh cage for single level corpectomy. Journal of Clinical Neuroscience 15:1227–1234PubMedCrossRef
16.
go back to reference Ying Z, Xinwei W, Jing Z et al (2007) Cervical corpectomy with preserved posterior vertebral wall for cervical spondylotic myelopathy: a randomized control clinical study. Spine 32:1482–1487PubMedCrossRef Ying Z, Xinwei W, Jing Z et al (2007) Cervical corpectomy with preserved posterior vertebral wall for cervical spondylotic myelopathy: a randomized control clinical study. Spine 32:1482–1487PubMedCrossRef
17.
go back to reference Meyer SA, Wu JC, Mummaneni PV (2011) Laminoplasty outcomes: is there a difference between patients with degenerative stenosis and those with ossification of the posterior longitudinal ligament? Neurosurg Focus 30:E9PubMedCrossRef Meyer SA, Wu JC, Mummaneni PV (2011) Laminoplasty outcomes: is there a difference between patients with degenerative stenosis and those with ossification of the posterior longitudinal ligament? Neurosurg Focus 30:E9PubMedCrossRef
18.
go back to reference Hirabayashi K, Watanabe K, Wakano K et al (1983) Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 8:693–699PubMedCrossRef Hirabayashi K, Watanabe K, Wakano K et al (1983) Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 8:693–699PubMedCrossRef
19.
go back to reference Hwang SL, Lee KS, Su YF et al (2007) Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease. J Spinal Disord Tech 20:565–570PubMedCrossRef Hwang SL, Lee KS, Su YF et al (2007) Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease. J Spinal Disord Tech 20:565–570PubMedCrossRef
20.
go back to reference Kepler CK, Rawlins BA (2010) Mesh cage reconstruction with autologous cancellous graft in anterior cervical discectomy and fusion. J Spinal Disord Tech 23:328–332PubMedCrossRef Kepler CK, Rawlins BA (2010) Mesh cage reconstruction with autologous cancellous graft in anterior cervical discectomy and fusion. J Spinal Disord Tech 23:328–332PubMedCrossRef
21.
go back to reference Eck KR, Bridwell KH, Ungacta FF et al (2000) Analysis of titanium mesh cages in adults with minimum two-year follow-up. Spine 25:2407–2415PubMedCrossRef Eck KR, Bridwell KH, Ungacta FF et al (2000) Analysis of titanium mesh cages in adults with minimum two-year follow-up. Spine 25:2407–2415PubMedCrossRef
22.
go back to reference Riew KD, Rhee JM (2002) The use of titanium mesh cages in the cervical spine. Clin Orthop Relat Res 394:47–54PubMedCrossRef Riew KD, Rhee JM (2002) The use of titanium mesh cages in the cervical spine. Clin Orthop Relat Res 394:47–54PubMedCrossRef
23.
go back to reference Chuang HC, Cho DY, Chang CS et al (2006) Efficacy and safety of the use of titanium mesh cages and anterior cervical plates for interbody fusion after anterior cervical corpectomy. Surg Neurol 65:464–471PubMedCrossRef Chuang HC, Cho DY, Chang CS et al (2006) Efficacy and safety of the use of titanium mesh cages and anterior cervical plates for interbody fusion after anterior cervical corpectomy. Surg Neurol 65:464–471PubMedCrossRef
24.
go back to reference Bilbao G, Duart M, Aurrecoechea JJ et al (2010) Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies. Acta Neurochir (Wien) 152:1155–1163CrossRef Bilbao G, Duart M, Aurrecoechea JJ et al (2010) Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies. Acta Neurochir (Wien) 152:1155–1163CrossRef
25.
go back to reference Kim HW, Ryu JI, Bak KH (2011) The safety and efficacy of cadaveric allografts and titanium cage as a fusion substitutes in pyogenic osteomyelitis. J Korean Neurosurg Soc 50:348–356PubMedCrossRef Kim HW, Ryu JI, Bak KH (2011) The safety and efficacy of cadaveric allografts and titanium cage as a fusion substitutes in pyogenic osteomyelitis. J Korean Neurosurg Soc 50:348–356PubMedCrossRef
26.
go back to reference Acosta FL Jr, Aryan HE, Chou D et al (2008) Long-term biomechanical stability and clinical improvement after extended multilevel corpectomy and circumferential reconstruction of the cervical spine using titanium mesh cages. J Spinal Disord Tech 21:165–174PubMedCrossRef Acosta FL Jr, Aryan HE, Chou D et al (2008) Long-term biomechanical stability and clinical improvement after extended multilevel corpectomy and circumferential reconstruction of the cervical spine using titanium mesh cages. J Spinal Disord Tech 21:165–174PubMedCrossRef
27.
go back to reference DiAngelo DJ, Foley KT, Vossel KA et al (2000) Anterior cervical plating reverses load transfer through multilevel strut-grafts. Spine 25:783–795PubMedCrossRef DiAngelo DJ, Foley KT, Vossel KA et al (2000) Anterior cervical plating reverses load transfer through multilevel strut-grafts. Spine 25:783–795PubMedCrossRef
28.
go back to reference Chen Y, Chen D, Yang L et al (2010) Three-dimensional finite elements study of a new titanium mesh cage for bone grafting. J Spinal Surg l8:290–294 (in Chinese) Chen Y, Chen D, Yang L et al (2010) Three-dimensional finite elements study of a new titanium mesh cage for bone grafting. J Spinal Surg l8:290–294 (in Chinese)
Metadata
Title
Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion
Authors
Yu Fengbin
Miao Jinhao
Liao Xinyuan
Wang Xinwei
Chen Yu
Chen Deyu
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 12/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-2976-1

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