Individual designed titanium mesh used in bone graft fusion and internal fixation to restore cervical curvature

doi:10.3969/j.issn.2095-4344.2014.17.006

Abstract

Abstract:

BACKGROUND: Titanium mesh is a new type of bone graft supports used for the treatment of spine, especially the cervical spine disorders at home and abroad in recent years. But, at present, how to improve the cervical lordosis curvature during anterior surgery is the difficulty for the treatment of cervical spondylotic myelopathy.
OBJECTIVE: To observe the effect of straight titanium mesh and individual designed titanium mesh used in the bone graft fusion and internal fixation on the recovery of cervical curvature and Japanese Orthopaedic Association score during anterior cervical subtotal vertebrectomy in the patients with cervical spondylotic myelopathy.
METHODS: Forty-three patients with cervical spondylotic myelopathy treated with surgical indications of subtotal vertebrectomy and decompression internal fixation were included, and the patients were divided into two groups according to different internal fixation methods. There were 15 cases in the individual designed titanium mesh group and 28 cases in the straight titanium mesh group. The preoperative anteroposterior X-ray films of the cervical spine of all the patients were as the blank control group. The clinical data of the patients in two groups were retrospectively analyzed, and the postoperative Japanese Orthopaedic Association score, cervical curvature, intervertebral angles and intervertebral height were compared.
RESULTS AND CONCLUSION: The cervical lordosis angle and the intervertebral angle of surgery segment in the individual designed titanium mesh group were improved when compared with those in the straight titanium mesh group and the blank control group (P < 0.01), and the straight titanium mesh group was better than the blank control group (P < 0.05). The intervertebral height of surgery segment in the individual designed titanium mesh group and the straight titanium mesh group was increased for 3.69 mm and 3.22 mm respectively when compared with that in the blank control group, and there was significant difference between individual designed titanium mesh group and the straight titanium mesh group (P > 0.05). There was no significant difference in Japanese Orthopaedic Association score between individual designed titanium mesh group and the straight titanium mesh group (P > 0.05). During subtotal vertebrectomy for the treatment of cervical spondylotic myelopathy, cutting titanium mesh into trapezoidal shape to simulate the normal disc shape of former high to low can effectively restore the physiological curvature of cervical spine and the intervertebral height of surgery segment.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: cervical vertebrae, individualized medicine, bone transplantation, internal fixators

CLC Number:

R318

Wen Rui, Ye Fei, Pu Hai-bo, Wei Shu-yi . Individual designed titanium mesh used in bone graft fusion and internal fixation to restore cervical curvature[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(17): 2655-2658.

Figures/Tables 1

References

[1] 李晓光,张凯宁,任延军.脊髓型颈椎病手术方式的选择[J].中国矫形外科杂志,2004,12(19):1456-1458.
[2] Cook SD,Dalton JE,Tan EH. In vivo evaluation of anterior cervical fusions with hydroxylapatite graft material.Spine. 1994; 19(6):1856-1866.
[3] 贾连顺,李家顺.颈椎外科手术学[M].上海：远东出版社,2001: 138-141.
[4] 王成林,董汉彬,王敏,等.颈椎侧位平片对生理曲度异常分型及早期颈椎病诊断价值研究[J].现代医用影像学,2000,9(5):201-204.
[5] 徐建伟,贾连顺,陈得玉,等.颈椎前路椎体次全切除钛网植骨早期塌陷探讨[J].中国矫形外科杂志,2002,10(13):1267-1269.
[6] Naderi S, Ozgen S, Pamir MN, et al. Cervical spondylotic myelopathy:surgical results and factors affecting prognosis. Neurosurg. 1998;43(1):4350.
[7] Goto S, Kita T. Long-term followup evaluation of surgery for ossification of the posterior longitudinal ligament. Spine. 1995;20(20):2247-2256.
[8] Goto S, Mochizuki M, Kita T, et al. Anterior surgery in four consecutive technical phases cervical spondylotic myelopathy. Spine. 1993;18(14):1968-1973.
[9] Das K,Couldwell WT,Sava G,et al.Use of cylindrical titanium mesh and locking plates in anterior cervical fusion.J Neurosurg. 2001;94(1Suppl):174-178.
[10] 罗家明,吴小涛,何海军. 颈前路多节段椎体次全切除钛笼植入重建颈椎生理弧度的实验研究[J].东南大学学报:医学版, 2006, 46(3):200-204.
[11] 翟剑亭,魏君虎,甘华,等.带锁钢板及钛质网笼植骨在颈椎前路手术中的应用[J].中国实用医药,2011,6(26):25-26.
[12] 赵筑川,曹永飞,彭智,等.颈椎前路钛网钢板内固定及自体髂骨植骨在不同颈椎节段中的生物力学研究[J].中国修复重建外科杂志, 2006,20(11):1076-1079.
[13] 蔡力,贺仕雄,姚国荣,等.不同形状钛网植入后植骨界面的生物力学性能[J].中国组织工程研究与临床康复,2010,14(48): 8980-8983.
[14] 张传毅,王章富,洪正华,等.钛网植骨融合在颈椎和胸腰椎手术中下沉因素的探讨[J].中国高等医学教育,2010,24(6):141-142.
[15] 谢江,孟祥玉,郭海龙.钛网植骨联合颈前路钢板治疗多节段颈椎病的临床应用[J].新疆医科大学学报,2010,33(6):682.
[16] 吕碧涛,袁文,徐蕾,等.钛网和自体髂体块在颈椎前路减压融合中应用的对比性研究[J].中国脊柱脊髓杂志,2004,14(7):1518.
[17] 沈雄杰,黄象望,张毅,等.颈椎前路减压钛网植骨融合术后内固定早期失败原因及预防[J].医学临床研究,2012, 29(2):1488-1489.
[18] 苏再发,贾连顺,张美超,等.颈椎椎体次全切除与钛网植骨钢板固定三维有限元模型的建立[J].医用生物力学,2009,24(3): 183-188.
[19] 高松明,刘志昂,高军胜,等.颈椎前路钛网植骨钢板内固定治疗脊髓型颈椎病[J].医药论坛杂志,2010,31(13):137-138.