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The application of a new type of titanium mesh cage in hybrid anterior decompression and fusion technique for the treatment of continuously three-level cervical spondylotic myelopathy

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Abstract

Purpose

To evaluate the efficacy and safety of a new type of titanium mesh cage (NTMC) in hybrid anterior decompression and fusion method (HDF) in treating continuously three-level cervical spondylotic myelopathy (TCSM).

Methods

Ninety-four cases who had TCSM and accepted the HDF from Jan 2007 to Jan 2010 were included. Clinical and radiological outcomes were compared between cases who had the NTMC (Group A, n = 45) and traditional titanium mesh cage (TTMC, Group B, n = 49) after corpectomies. Each case accepted one polyetheretherketone cage (PEEK) after discectomy.

Results

Mean follow-up were 74.4 and 77.3 months in Group A and B, respectively (p > 0.05). Differences in cervical lordosis (CL), segmental lordosis (SL), anterior segmental height (ASH) and posterior segmental height (PSH) between two groups were not significant preoperatively, 3-days postoperatively or at final visit. However, losses of the CL, SL, ASH and PSH were all significantly larger in Group B at the final visit, so did incidences of segmental subsidence and severe subsidence. Difference in preoperative Japanese Orthopedic Association (JOA), visual analog scale (VAS), neck disability index (NDI) or SF-36 between two groups was not significant. At the final visit, fusion rate, JOA, and SF-36 were all comparable between two groups, but the VAS and NDI were both significantly greater in Group B.

Conclusions

For cases with TCSM, HDF with the NTMC and TTMC can provide comparable radiological and clinical improvements. But application of the NTMC in HDF is of advantages in decreasing the subsidence incidence, losses of lordosis correction, VAS and NDI.

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedics, Jinling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China

      Xiaowei Liu, Haidong Xu & Bin Xu

    2. Department of Spine Surgery, Changzheng Hospital, The Second Military Medicine University, No. 415, Road Fengyang, Shanghai, 200003, China

      Yu Chen, Haisong Yang, Tiefeng Li & Deyu Chen

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    1. Xiaowei Liu
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    2. Yu Chen
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    7. Deyu Chen
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    Correspondence to Deyu Chen.

    Ethics declarations

    The Institutional Review Board approval, which was consistent with the Helsinki Declaration was approved by the Ethical Committee of Changzheng Hospital. Each case signed the informed consent before accepting the operation. No relevant financial activities outside the submitted work and no other potential conflicts.

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    The authors declare that they have no conflict of interest.

    Additional information

    X. Liu and Y. Chen have made equal contribution to this article, and should be regarded as co-first author.

    Bin Xu: Co-corresponding Author for this submitted manuscript.

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    Liu, X., Chen, Y., Yang, H. et al. The application of a new type of titanium mesh cage in hybrid anterior decompression and fusion technique for the treatment of continuously three-level cervical spondylotic myelopathy. Eur Spine J 26, 122–130 (2017). https://doi.org/10.1007/s00586-016-4888-3

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