Comparison of 3D printed cervical spine with titanium mesh cage for fractures of lower cervical spine

Abstract

Objective To compare the effectiveness of 3D cervical spine versus titanium mesh cage in the treatment of fractures of lower cervical vertebrae. Methods From May 2016 to March 2017, a total of 31 patients with cervical spine fracture were enrolled in this prospective randomized controlled trial at Department of Orthopaedics, Luohe Central Hospital. Of them, 16 cases were randomized to receive anterior cervical sub-total resection and decompression followed by internal fixation with implant of 3D printed cervical spine (3D group) and 18 to receive anterior cervical sub-total resection and decompression followed by internal fixation with implant of titanium mesh cage (TM group). The 2 groups were compared in terms of operation time, intraoperative bleeding, score and improvement rate of Japanese Orthopaedic Association (JOA), vertebral height change, cobb angle change and bone graft fusion. Results Eventually, included for this study were 15 cases in the 3D group and 16 in the TM group who had been completely followed up. Operations were well done for all the patients. The operation time for the 3D group (83.9±21.4 min) was significantly shorter than that for the TM group (116.2±27.8 min) (t=5.039, P 0.05). The vertebral heights and cobb angles at postoperative 3 months and at the final follow-up in the 3D group were significantly larger than those in the TM group (P 0.05). The incidence of prosthesis settlement in the 3D group (6.7%) was significantly lower than that in the TM group (43.75%) (P< 0.05). Conclusions Both surgical procedures can reconstruct cervical stability. Compared with titanium mesh cage, 3D printed cervical spine may lead to shorter operation time, better bone-material bonding interface, less prosthesis sinking and superiority in maintaining the cervical height and curvature. Key words: Cervical vertebrae; Fractures, bone; Dislocation; Titanium mesh cage; 3D printed microporous titanium vertebral body