Abstract
Background Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. The selection of a proper rod material is crucial due to their specific mechanical properties that influence the surgical outcome. The purpose of this study is to compare the effectiveness of cobalt chromium rods versus titanium rods for the treatment of spinal deformity by a systematic review and meta-analysis. Methods PubMed, EMBASE, and the Cochrane library were searched for observational and biomechanical studies comparing cobalt chromium and titanium rods in terms of correction rate, thoracic kyphosis, lumbar lordosis, incidence of rod fracture, fatigue life of contoured rod, bending stiffness of rods, and occurrence of proximal junctional kyphosis. The demographic data and mean values of outcomes of interest were extracted from each group and compared by their mean difference as an overall outcome measure. The Review Manager software (RevMan 5.3) was utilized at a 95% significance level. Results Eleven eligible studies with 641 participants for 7 observational studies and 35 samples for 4 biomechanical studies were identified. There were no significant differences between cobalt chromium and titanium rods in the correction rate of spinal deformity. Postoperative thoracic kyphosis was well restored in the cobalt chromium group with statistical significance (p value = 0.009). The incidence of rod fracture was high in titanium rods compared to cobalt chromium rods with significant difference (p value = 0.0001). Proximal junctional kyphosis occurs more in the cobalt chromium group with a significant difference (p value = 0.0009). No statistical significance between two materials in terms of lumbar lordosis, fatigue of life, and bending stiffness of rods. Conclusion The cobalt chromium rod is better than titanium rod for effective correction of spinal deformity and postoperative stability of the spine. However, the use of cobalt chromium rods is associated with increased risk of proximal junctional kyphosis.
Highlights
Spinal deformity, one of the commonest orthopedic disorders, is a malformation or malalignment of the vertebral column
In this study, we found that the postoperative thoracic kyphosis angle was well restored with the use of cobalt chromium rods than in the titanium rod group; there was a significant difference between them (p value 0.009); the results align with those reported by Etemadifar et al [26]
The findings of our study showed that there is no statistical significance in changes of lumbar lordosis with a p value of 0.77, which align with results reported by Han et al [17]
Summary
Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. e selection of a proper rod material is crucial due to their specific mechanical properties that influence the surgical outcome. e purpose of this study is to compare the effectiveness of cobalt chromium rods versus titanium rods for the treatment of spinal deformity by a systematic review and meta-analysis. Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. PubMed, EMBASE, and the Cochrane library were searched for observational and biomechanical studies comparing cobalt chromium and titanium rods in terms of correction rate, thoracic kyphosis, lumbar lordosis, incidence of rod fracture, fatigue life of contoured rod, bending stiffness of rods, and occurrence of proximal junctional kyphosis. Ere were no significant differences between cobalt chromium and titanium rods in the correction rate of spinal deformity. Postoperative thoracic kyphosis was well restored in the cobalt chromium group with statistical significance (p value 0.009). Proximal junctional kyphosis occurs more in the cobalt chromium group with a significant difference (p value 0.0009). E cobalt chromium rod is better than titanium rod for effective correction of spinal deformity and postoperative stability of the spine. The use of cobalt chromium rods is associated with increased risk of proximal junctional kyphosis
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