Abstract:

BACKGROUND: Titanium mesh as a new kind of bone graft implants has been commonly used in spinal surgery because the advantages of good instant stability, maintenance of cervical curvature, surgical angle of the intervertebral segment, prevention of donor area complications, and high fusion rate. However, there has no consensus or a standard for trimming in titanium mesh surgery.
OBJECTIVE: To investigate effect of individualized design titanium mesh on the recovery of cervical curvature and to test the biomechanical properties of bone interface after Trapezoidal titanium mesh implant.
METHODS: A total of 16 cervical specimens with no difference in bone mineral density underwent C₅ corpectomy, and 8 specimens were randomly selected as straight-shaped titanium mesh group, the others as trapezoidal titanium mesh group. The mesh was trimmed and implanted. Cervical curvature, intervertebral angle, disc height, the maximum load (N) of narrowing the operation intervertebral height 1 mm, and stiffness were measured.
RESULTS AND CONCLUSION: Cervical lordosis angle in straight-shaped titanium mesh group and trapezoidal titanium mesh group was significantly greater than the blank control group (P < 0.05, P < 0.01), especially the trapezoidal titanium mesh group was greater. Intervertebral height of trapezoidal titanium mesh group and common titanium mesh group was increased 3.71 mm and 3.25 mm compared with the blank control group (P < 0.01), but no difference was observed between trapezoidal titanium mesh group and common titanium mesh group (P > 0.05). The maximum load and stiffness to narrow the gap of surgery 1 mm of trapezoidal titanium mesh group were significantly greater than common titanium mesh group (all P < 0.05). Results showed that individualized titanium mesh can simulate the normal disc shape, and under certain interbody distraction, it can effectively restore the physiological curvature of cervical spine and angle of the surgical intervertebral segment. It adapts for the high-low morphological characteristics of intervertebral space, and exhibits biomechanical properties.