title: Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion.
abstract: METHODS
  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.
authors.affiliation: Department of Orthopaedic Surgery, No. 98 Hospital of PLA, No. 9 Chezhan Road, 313000, Huzhou, China, yufengbin1977@sina.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fengbin
authors.forename: Miao
authors.initials: M
authors.lastname: Jinhao
authors.forename: Liao
authors.initials: L
authors.lastname: Xinyuan
authors.forename: Wang
authors.initials: W
authors.lastname: Xinwei
authors.forename: Chen
authors.initials: C
authors.lastname: Yu
authors.forename: Chen
authors.initials: C
authors.lastname: Deyu
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D055009:Spondylosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium