Single-Level Anterior Cervical Corpectomy and Fusion Using a New 3D-Printed Anatomy-Adaptive Titanium Mesh Cage for Treatment of Cervical Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament: A Retrospective Case Series Study.

Abstract

BackgroundThe aim of this study was to evaluate the clinical and radiological outcomes of the use of a new 3D-printed anatomy-adaptive titanium mesh cage (AA-TMC) for single-level anterior cervical corpectomy and fusion (ACCF) in patients with cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL).Material/MethodsWe retrospectively reviewed the records of 15 consecutive patients who underwent ACCF surgeries with AA-TMC implantation. The Japanese Orthopedic Association (JOA) scoring system, a visual analogue scale (VAS), the mean intervertebral height (MIBH) of the surgical segments, and the surgical segmental angle (SSA) were recorded preoperatively, immediately after surgery and at the final follow-up visit. The outcomes of these parameters at different time points were compared.ResultsSix months after ACCF surgery, solid bony fusions of the surgical level were achieved in all patients. The mean MIBH was 21.05±1.99 mm preoperatively, 27.51±1.44 mm immediately after surgery (P<0.05), and 26.85±1.25 mm at the last follow-up visit (P<0.05). At the last follow-up visit, none of the AA-TMCs exhibited severe subsidence (>3 mm). The mean SSA was 6.66±7.08° preoperatively, 14.03±2.3° immediately after surgery (P<0.05), and 15.09±2.1° at the final follow-up visit (P>0.05). The mean VAS and JOA scores were 6.6±1.26 and 10.47±2.07, respectively, preoperatively and 2.47±1.3 and 13.6±1.96 immediately after surgery, respectively (P<0.05). At the last follow-up visit, the mean VAS and JOA were further restored to 1.67±1.18 and 14.9±1.39, respectively (P<0.05).ConclusionsThe application of the AA-TMC in single-level ACCF significantly relieved symptoms of CSM and OPLL. The rational design of the AA-TMC restores the surgical segmental curvature, maintains the intervertebral height, and prevents postoperative subsidence-related complications.