Effect Of Titanium Mesh Sinking After Anterior Cervical Spine Surgery On The Surgical Outcome And The Factors Associated With Subsidence

Objective: To explore the effect of titanium mesh sinking after anterior cervical spine surgery and to analyze the correlation factors of titanium mesh subsidence.Methods: A retrospective analysis of our department in September2013 ~2015 05 months in our hospital diagnosis of spinal type cervical spondylosis parallel single segment anterior cervical spine decompression decompression + titanium mesh fusion + titanium plate internal fixation of 40 cases of patients. According to the postoperative 6 months of lateral cervical radiographs measuring, divided into sinking group and non sinking group were observed, with JOA score measure the curative effect of postoperative titanium mesh subsidence of surgical treatment effect and age, sex, surgical segment, vertebral distraction angle and titanium mesh subsidence correlation.Results: Sink group 11 cases, non sinking group 29 cases, the sink rate of 27.5%. Sink group mean age 56.73 + 8.22 years old, non sinking group with mean age 48.97 + 4.10; sinking group male 4 cases, female 7cases, non sinking group male 17 cases, female 12 cases. Sink group corpectomy C4 segment in 1 cases, 3 cases of C5 segment, C6 segment in7 cases, non sinking group corpectomy C4 segment in 8 cases, 15 cases of C5 segment, C6 segment in 6 cases. Sink group vertebral distraction angle is less than 20 degrees group in 3 cases, greater than or equal to 20degrees(8 cases) and non sinking group vertebral distraction angle is less than 20 degrees group 20 cases, greater than or equal to 20 degrees group(9 cases). Preoperative JOA score sink group average 7.80 + 1.60 and non sinking group average of 8.10 + 1.90 points, the difference was not statistically significant(P > 0.05). The postoperative JOA score sink group average 13.59 + 2.50 points and non sinking 14.23 + 2.80%, the difference was not statistically significant(P > 0.05). The postoperative JOA scores of the two groups were significantly improved, and the difference was statistically significant(P < 0.05). Multivariate analysis of age, surgical section, postoperative vertebral distraction angle for sinking the influencing factors. With the increase of age, were sinking more serious(OR=1.191, 95% CI 1.047~1.355) and surgical segment C6 relative to C4, the patients of sink more serious(OR=10.710, 95% CI1.335~85.900). Postoperative vertebral distraction angle greater than equal to 20 degrees group compared with less than 20 degrees group,patients with sinking more serious(OR=5.512, 95% CI 1.038~29.262).Conclusion: Titanium mesh subsidence after anterior cervical single segment ACCF had no influence on the operation effect to some extent.Age, surgical segment and vertebral distraction angle have differenteffects on the occurrence of titanium mesh subsidence. The older,titanium mesh subsidence rate is higher; C3-6 segment in the C6 segment sink has the highest incidence rate; vertebral distraction greater perspective is more likely to happen titanium net sink.Master surgical indications, correctly handle the vertebral endplate,the appropriate angle of distraction, choose the suitable titanium plate,choose suitable titanium mesh and correct pruning can be in a certain extent, prevent or reduce the occurrence of postoperative subsidence of titanium mesh.