Efficacy and safety of the use of titanium mesh cages and anterior cervical plates for interbody fusion after anterior cervical corpectomy.
BACKGROUND
To determine the safety and effectiveness of the use of titanium mesh cages (TMCs) and anterior cervical plates (ACPs) for interbody fusion after anterior cervical corpectomy.


METHODS
From June 2001 to June 2003, 15 patients underwent reconstruction with TMCs and ACPs for interbody fusion after anterior cervical corpectomy in our hospital. The mean follow-up is 13.6 months (range, 9-24 months). Subjects included those with cervical degenerative, traumatic, or pathological diseases. Titanium mesh cages were filled with autologous bone grafts taken from the corpectomy and iliac crest bone chips and were all filled with triosite (calcium phosphate ceramics). The patients' observable signs, neurological reconstruction results, and complications were fully and explicitly recorded throughout the procedure. Radiological imaging studies for measurements of coronal and sagittal angles, sagittal displacements, and settling ratio changes were performed to evaluate spinal stability. We used axial cervical computed tomography (CT) and reconstructive sagittal cervical CT to demonstrate interbody fusion within titanium mesh.


RESULTS
The alleviation and frequent disappearance of the subjects' original symptoms and the significant neurological recovery obvious in most patients indicated that postoperative spinal stability could be well maintained. No significant differences in mean cage height-related settling rates, mean sagittal displacements, and mean coronal and sagittal angle changes were observed between 1-level and multilevel corpectomy. All patients who received axial and reconstructive sagittal cervical CT scan could demonstrate true interbody fusion within TMC, and no nonunions were present. Cage malplacement was observed in one subject who had neck pain and neck stiffness, rather than from radiculopathy or myelopathy. One subject died of acute myocardial infarction. There were no ceramic-related complications.


CONCLUSIONS
Based on preliminary findings from this study, reconstruction involving TMC interbody fusion with ACP fixation after anterior cervical corpectomy serves as an effective and safe method for the treatment of cervical disease.
Chuang
Hao-Che
HC
Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan 404, Republic of China.
Cho
Der-Yang
DY
Chang
Cheng-Siu
CS
Lee
Wen-Yuen
WY
Jung-Chung
Chen
C
Lee
Han-Chung
HC
Chen
Chun-Chung
CC
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000379:methods*; D013526:Surgical Mesh / Q000009:adverse effects; D014025:Titanium / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
D014025:Titanium