Research Of Subsidence Problem Of Titanium Mesh Cage In Anterior Cervical Subcorpectomy Bone Graft And Fusion

Objective To compare the incidence and progress of titanium mesh subsidence in anterior cervical subcorpectomy bone graft and fusion with single or multiple segments.Methods We retrospectively analyzed47patients from2006to2010,who underwent implantation of Titanium mesh filled with autologous bone grafts taken from the corpectomy and the iliac crest chips at various segments were involved.^Subcorpectomy was performed on one segment (21cases),2segments (18cases),3segments (8cases)。The preoperative and postoperative JOA score、Odom Criteria were collected as well as the postoperative complications.Radiological measurements of sagittal angles changes of3、6months after operation were performed to evaluate the incidence and progress of titanium mesh subsidence.Results All the cases were documented over a mean follow-up duration of25months(6-46months). X-ray showed solid fusion of the titanium mesh in all cases3months after the operation. titanium mesh subsidence was observed in3cases(all of them are anterior-posterior approach). All cases were observed the sagittal angle changes of fixed vertebrae with different degrees after the operation:3months after the operation30cases without subsidence, the change is2.08-11.88°,5.51°on average;3cases with subsidence, the angle change is12.00-21.26°,15.67°on average。6months after the operation,30cases without subsidence, compared to 3-month’result,the angle change is0.38～3.51°,1.21°on average;3cases with subsidence, compared to3-month’result,the angle change is1.06～4.75°,2.37°on average。Conclusions Because of the finite screws strength in the titanium mesh,the subsidence possibility of the internal fixation exists,which progesses fast in the first3months,then slows down.The implantation of multiple segments has higher risk to suffer subsidence but it doesn’t affect the solid fusion.