A Mid-and-Long Term Follow-up Of Titanium Mesh Subsidence After Anterior Cervical Corpectomy Reconstructed With Titanium Mesh And Bone Graft

Objective To analyze the influence of the titanium mesh subsidence on clinical effects, cervical curvature, adjacent segment disease, fusion rate and so on.Methods From June 2010 to June 2013,a total of 168 patients with diagnosis of cervical myelopathy with anterior cervical corpectomy implant titanium mesh cage. Eighteen patients with subsidence after corpectomy were selected. analyze the influence of the titanium mesh subsidence on clinical effects, cervical curvature, adjacent segment disease, fusion rate and so on.Results JOA grades in all patients before the surgery were 10.89±2.97 points. JOA grades in all patients in three months after the surgery were 14.06±1.65 points. JOA grades in all patients at the last follow-up were 13.72±1.96 points. Compare JOA grades between the pre-operation and the last follow-up with significant defference(P<0.05). Compare JOA grades between the pre-operation and the three months after surgery with significant defference(P<0.05). Compare JOA grades between the three months after surgery and the last follow-up without significant defference(P>0.05). The postoperative immediate adjacent vertebral body Cobb angle were 6.66±8.32.the adjacent vertebral body Cobb angle of the three months after the surgery were 6.81±5.56.The adjacent vertebral body Cobb angle of the last follow-up were 5.24±6.15. Compare the adjacent vertebral body Cobb angle between postoperation immediate and the three months after the surgery without significant defference(P>0.05). Compare the adjacent vertebral body Cobb angle between postoperation immediate and the last follow-up with significant defference(P<0.05). The postoperative immediate cervical spine Cobb angle were 10.42±10.13.The cervical spine Cobb angle of the three months after the surgery were 11.99±8.62.The cervical spine Cobb angle of the last follow-up were 10.86±10.36. Compare the cervical spine Cobb angle between postoperation immediate and the three months after the surgery with significant defference(P<0.05). Compare the cervical spine Cobb angle between postoperation immediate and the last follow-up without significant defference(P>0.05).Fourteen patients had mild adjacent segment disease. Four patients had moderate adjacent segment disease.Four patients had the absence of lucency or halo around the screw or cage-bone interfaces.Fusion rate 77.8%.Conclusion The titanium mesh subsidence has no effect on cervical curvature and clinical effects.But it may increase the incidence of the adjacent segment disease and the movement of the screw.