Impact of titanium mesh cage slotting width on anterior cervical corpectomy and fusion for compression cervical spondylosis with MRI T2WI hyperintensity: a one-year follow-up study

被引：0
作者：
Yu, Rongguo [1 ]
Yuan, Xiurong [2 ]
Huang, Kangkang [1 ]
Wu, Tingkui [1 ]
Wang, Hong [1 ]
Ding, Chen [1 ]
Wang, Beiyu [1 ]
Liu, Hao [1 ]
机构：
[1] Sichuan Univ, West China Hosp, Orthoped Res Inst, Dept Orthoped, Chengdu 610041, Sichuan, Peoples R China
[2] Sichuan Univ, West China Hosp, West China Sch Nursing, Dept Orthoped, Chengdu, Peoples R China
来源：
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH | 2024年 / 19卷 / 01期
关键词：
Titanium Mesh Cage; Anterior cervical corpectomy and Fusion; Cervical spondylosis; T2-weighted imaging hyperintensity; Spinal cord Compression; Slotting Width; Radiological outcomes; Spinal Stability; Decompression; Spinal Cord Signal Improvement; MYELOPATHY; SURGERY;
D O I：
10.1186/s13018-024-05339-x
中图分类号：
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
Background Anterior cervical corpectomy and fusion (ACCF) is a standard surgical procedure for cervical spondylosis with spinal cord compression (CSWSCC), especially in patients with intensity on T2-weighted imaging high signal (T2WIHS). The titanium mesh cage (TMC) utilized in this procedure is essential in stabilizing the spine; however, the optimal slotting width of the TMC remains unclear. Objective This study aimed to investigate the impact of TMC slotting width on the clinical and radiological outcomes of ACCF in patients with spinal cord compression type cervical spondylosis with intensity on T2WIHS (CST2WIHS). Methods We retrospectively analyzed 69 patients who underwent single-level ACCF between December 2010 and October 2021. The patients were divided into narrower (< 2 mm) and wider (> 2 mm) groups based on the slotting width of the TMC. The Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores were used to assess clinical outcomes. Radiological outcomes included cervical lordosis (CL), functional spinal unit (FSU) height, transverse decompression range (TDR), spinal canal area (SCA), TMC alignment, and subsidence and fusion rates. Results Patients in both groups exhibited significant postoperative improvement in NDI and JOA scores (P < 0.05). Radiologically, patients in the wider slotting group exhibited better decompression, evidenced by a larger TDR (P < 0.01) and smaller postoperative SCA (P < 0.01) than the narrow group. Regarding CL, FSU height, TMC alignment, subsidence, or fusion rates, the groups did not differ significantly. Although statistically non-significant, patients in the wider group exhibited a trend towards improvement in spinal cord signal intensity than those in the narrower group. Conclusion The study demonstrated that a wider TMC slotting width offers superior decompression and may improve postoperative spinal cord signal; it does not compromise spinal stability or fusion outcomes. These findings indicate that slotting width should be carefully considered in ACCF procedures to optimize decompression and spinal cord recovery.
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页数：10
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