Evaluation Of The Effect On Cervical Curvature Of Intervertebral Fusion With Titanium Mesh

Objective:To determine whether a difference exists in cervical lordotic alignment after patients receiving anterior cervical discectomy and fusion(ACDF)with anterior plating and placing titanium mesh,by following up the patients grafted with titanium mesh or self-iliac bone. Method:31 patients suffered from cervical spondylotic myelopathy treated surgically with anterior decompression and fusion with anterior plating and placing titanium mesh were followed with four months to twelve months.And 21 patients operated with anterior decompression and fusion with self-iliac bone were followed with six months to nineteen months.Neutral lateral cervical radiographs of patients were assessed preoperatively and at least 3 months after surgery.Measurements were made on the radiographs to assessed overall sagittal spinal alignment and intersegmental sagittal alignment at the surgical site,height of anterior and posterior intervertebral border. Result: After surgery ,in the titanium group,the average magnitude of overall lordosis measured between C2 and C7(absolute rotation angle) decreased 0.9°(p=0.149),at the surgical site,the segmental contribution to lordosis(relative rotation angle) increased an average 2.3°(p<0.001),height of intervertebrae increased an average 3.38mm(p<0.001) at anterior border and 2.23mm(p<0.001)at posterior border.In the self-iliac bone group,the absolute rotation angle decreased 2.2°(P=0.006),and the relative rotation angle decreased 1.3°(P=0.017),height of intervertebrae decreased an average 2.79mm(P<0.001) at anterior border and 0.99mm(P=0.037) at posterior border.Further more,we found thatin the titanium group,the increased height of intervertebrae at anterior border after surgery was average 1.14mm more than the magnitude at posterior border,and difference was highly relative to the increased magnitude of segmental lordosis statistically(p=0.010). Conclusion:The segmental lordosis,and height of anterior and posterior intervertebral border could surely be increased when the titanium mesh was used in ACDF with anterior plating.So it could improve the prognosis of the patients and decrease the complication in the long-term following-up.But there was not same effect on overall lordosis,especially when the cervical curvature was lordosis primarily.