Comparative Analysis of 3D-Printed Artificial Vertebral Body Versus Titanium Mesh Cage in Repairing Bone Defects Following Single-Level Anterior Cervical Corpectomy and Fusion

Tao Fang, Ming Zhang, Jing Yan, Jiali Zhao, Wei Pan, Xinhong Wang, Quan Zhou, Tao Fang, Ming Zhang, Jing Yan, Jiali Zhao, Wei Pan, Xinhong Wang, Quan Zhou

Abstract

BACKGROUND The aim of this study was to compare the clinical and radiological outcomes of the 3D-printed artificial vertebral body vs the titanium mesh cage in repairing bone defects for single-level anterior cervical corpectomy and fusion (ACCF). MATERIAL AND METHODS A total of 51 consecutive patients who underwent single-level ACCF in Huai'an Second People's Hospital from July 2017 to August 2020 were retrospectively reviewed. According to the implant materials used, patients were divided into a 3D-printed artificial vertebral body group (3D-printed group) (n=20; 12 males, 8 females) and a titanium mesh cage group (TMC group) (n=31; 15 males, 16 females). General data, radiological parameters, and clinical outcomes were recorded. RESULTS The rate of subsidence in the 3D-printed group (0.01, 2/20) was lower than in the TMC group (0.29, 9/31) (P<0.05). HAE and HPE of the patients in the 3D-printed group were significantly higher than those in the TMC group (P<0.05). C2-C7 Cobb angle and SA of the patients in the 3D-printed group were significantly larger than those in the TMC group (P<0.05). All patients in the 2 groups showed significant improvement in VAS, JOA, and NDI scores at 3 months and 1 year after surgery. CONCLUSIONS 3D-printed artificial vertebral body helps maintain intervertebral height and cervical physiological curvature and is a good candidate for ACCF.

Figures

Figure 1
Figure 1
(A, C) Show examples of 3D-printed artificial vertebral bodies. (B, D) Show the examples of TMCs.
Figure 2
Figure 2
(A) Preoperative MRI showed obvious C6/7 intervertebral disc herniation, spinal stenosis, and nerve compression (B) 1 week after surgery, (C) 3 months after surgery, and (D) 1 year after surgery.
Figure 3
Figure 3
(A) Preoperative MRI showed compression and deformation of cervical spinal cord behind C4/C5 vertebral body (B) 1 week after surgery, (C) 3 months after surgery, and (D) 1 year after surgery.
Figure 4
Figure 4
Related evaluation indexes of patients in the 3D-printed group and TMC group at different time points. (A–D) 3D-printed group and TMC group preoperative and postoperative HAE and HPE. All data are expressed as mean±standard deviation. (0.01< * P<0.05, 0.001< ** P<0.01, and *** P<0.001).
Figure 5
Figure 5
Related evaluation indexes of patients in the 3D-printed group and TMC group at different time points. (A–D) 3D-printed group and TMC group preoperative and postoperative C2–C7 Cobb angles and SA. All data are expressed as mean±standard deviation. (0.01< * P<0.05, 0.001< ** P<0.01, and *** P<0.001).
Figure 6
Figure 6
Related evaluation indexes of patients in 3D-printed group and TMC group at different time points. (A–F) 3D-printed group and TMC group preoperative and postoperative NDI, JOA, and VAS scores. All data are expressed as mean±standard deviation. (0.01< * P<0.05, 0.001< ** P<0.01, and *** P<0.001).

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