Risk factors associated with titanium cage subsidence after anterior single-level subtotal corpectomy and interbody fusion using titanium cage

doi:10.3969/j.issn.2095-4344.1121

Abstract

Abstract:

BACKGROUND: Anterior single-level subtotal corpectomy and interbody fusion using titanium cage is a good method for anterior decompression of spinal cord, which can prevent the disease development and achieve satisfactory short-term curative efficacy. However, postoperative titanium cage subsidence is a commonest complication, and its risk factors still remain controversial, which is an issue of concern.

OBJECTIVE: To study the risk factors for titanium cage subsidence after anterior single-level subtotal corpectomy and interbody fusion using titanium cage.

METHODS: A retrospective analysis of 81 patients undergoing anterior single-level subtotal corpectomy and interbody fusion using titanium cage at First Affiliated Hospital of Guangxi University of Chinese Medicine from March 2012 to March 2016 was performed. The baseline data (sex, age, bone mineral density, bone mass index, history of smoking and disease type), intraoperative data (tilt angle, depth and type of titanium cage, angle of nail plate angle), and postoperative data (neck collar fixation time and postoperative working posture) were recorded. At 3 days and end of the follow-up (24 months) postoperatively, the cervical vertebrae underwent X-ray examination, and divided into titanium cage subsidence group (decreased height > 2 mm) and titanium cage non-subsidence group (decreased height < 2mm) according to the decreased height of the fused vertebrae. Univariate analysis between two groups was conducted on statistical software, and the factors with differences were included in the logistic regression analysis to obtain the risk factors related to the titanium cage subsidence.

RESULTS AND CONCLUSION: (1) All patients completed the trial, including 24 cases of titanium cage subsidence and 57 cases of titanium cage non-subsidence. (2) The sex, age, body mass index, occupational distribution, history of smoking, and postoperative working posture showed no significant difference between two groups (P > 0.05). There were significant differences in the bone mineral density, title angel, depth and types of titanium cage, angle of nail plate, and postoperative neck collar fixation time between two groups (P < 0.05). (3) Multivariate logistic regression analysis showed that the short fixation time of the neck collar was the risk factor for titanium cage subsidence (P < 0.05). The increase of the tilt angle of titanium cage was closely related to the titanium cage subsidence (P < 0.05). (4) To conclude, the fixation time of the neck collar and the tilt angle of the titanium cage are important risk factors for titanium cage subsidence, which should be highly valued in the clinic, so as to reduce the incidence of titanium cage subsidence and improve the postoperative efficacy.

Key words: Cervical Vertebrae, Spinal Fusion, Factor Analysis, Statistical, Tissue Engineering

CLC Number:

R459.9

Tang Fubo, Zhou Jinyan, Zhang Yisheng, Zhong Yuanming, Li Zhifei, Mo Yi. Risk factors associated with titanium cage subsidence after anterior single-level subtotal corpectomy and interbody fusion using titanium cage [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(12): 1818-1823.

Figures/Tables 5

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