The application of pre-curved titanium mesh cage in one-segment anterior cervical corpectomy and fusion

English Keywords:Cervical spondylotic myelopathy  Titanium mesh cage  Subsidence  Anterior cervical corpectomy and fusion

English Abstract:

  【Abstract】 Objectives: To evaluate the efficacy and safety of the application of pre-bending titanium mesh cage(TMC) in one-segment anterior cervical corpectomy and fusion(ACCF). Methods: Patients with cervical spondylotic myelopathy undergoing one-segment ACCF from January 2016 to January 2017 in our hospital were divided into pre-bending TMC group(n=39) and straight TMC group(n=43). Matched angle between the TMC ends and its adjacent endplates locating upper(UMD) or lower(LMD), anterior or posterior segment height(ASH or PSH), incidence of subsidence, rate of fusion, Japanese Orthopedic Association(JOA) and visual analog scale(VAS) score in two groups were compared. Results: The mean follow-up was 17.7±2.1 months and 18.4±2.4 months in pre-cured TMC group and straight TMC group, respectively. At final follow-up, the fusion rate in both groups was 100%, the changes of UMD/LMD in pre-bending TMC group(1.0°±0.7°/1.1°±0.6°) were significantly less than those in straight TMC group(1.9°±0.4°/2.2°±0.8°)(P<0.05). The ASH/PSH loss was -1.9±1.7mm/-1.5±1.6mm and the incidence of subsidence was 28.2% in pre-bending TMC group, while -1.9±1.7mm/-1.5±1.6mm and 53.4% in straight TMC group, and there were significantly differences between the two groups(P<0.05). There were significantly improvements in JOA and VAS scores in two groups, there were no significant differences in JOA score and neurological improvement rate between the two groups(P＞0.05). The VAS score in pre-bending TMC group(2.5±1.2) was significantly less than that in straight TMC group(3.2±0.8, P<0.05). Conclusions: The application of pre-bending TMC in one-segment ACCF can achieve better fitted with the upper and lower endplates and significantly reduce the loss of ASH and PSH and the subsidence of titanium mesh.