title: 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: To evaluate the efficacy and safety of a new type of titanium mesh cage (NTMC) in hybrid anterior decompression and fusion method (HDF) in treating continuously three-level cervical spondylotic myelopathy (TCSM).
  
  
  
  Ninety-four cases who had TCSM and accepted the HDF from Jan 2007 to Jan 2010 were included. Clinical and radiological outcomes were compared between cases who had the NTMC (Group A, n = 45) and traditional titanium mesh cage (TTMC, Group B, n = 49) after corpectomies. Each case accepted one polyetheretherketone cage (PEEK) after discectomy.
  
  
  
  Mean follow-up were 74.4 and 77.3 months in Group A and B, respectively (p > 0.05). Differences in cervical lordosis (CL), segmental lordosis (SL), anterior segmental height (ASH) and posterior segmental height (PSH) between two groups were not significant preoperatively, 3-days postoperatively or at final visit. However, losses of the CL, SL, ASH and PSH were all significantly larger in Group B at the final visit, so did incidences of segmental subsidence and severe subsidence. Difference in preoperative Japanese Orthopedic Association (JOA), visual analog scale (VAS), neck disability index (NDI) or SF-36 between two groups was not significant. At the final visit, fusion rate, JOA, and SF-36 were all comparable between two groups, but the VAS and NDI were both significantly greater in Group B.
  
  
  
  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.
authors.affiliation: Department of Orthopaedics, Jinling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Spine Surgery, Changzheng Hospital, The Second Military Medicine University, No. 415, Road Fengyang, Shanghai, 200003, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Spine Surgery, Changzheng Hospital, The Second Military Medicine University, No. 415, Road Fengyang, Shanghai, 200003, China.
authors.forename: Haisong
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Spine Surgery, Changzheng Hospital, The Second Military Medicine University, No. 415, Road Fengyang, Shanghai, 200003, China.
authors.forename: Tiefeng
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Jinling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, Jinling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Spine Surgery, Changzheng Hospital, The Second Military Medicine University, No. 415, Road Fengyang, Shanghai, 200003, China. chenspinecz@hotmail.com.
authors.forename: Deyu
authors.initials: D
authors.lastname: Chen
mesh_terms: D001577:Benzophenones; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation* / Q000379:methods; D004185:Disability Evaluation; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007659:Ketones; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011108:Polymers; D019736:Prostheses and Implants; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D055009:Spondylosis / Q000601:surgery*; D014025:Titanium; D064232:Visual Analog Scale
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium
keywords: Cervical spondylotic myelopathy; Hybrid anterior decompression and fusion; Subsidence; Titanium mesh cage