[Treatment of multilevel cervical intervertebral disc protrusion using titanium mesh cage with self-locked titanium...

To observe the effect of titanium mesh cage with self-locked titanium plate on the cervical inter-body fusion after anterior discectomy of multilevel cervical intervertebral disc protrusion.

The therapeutic effect of 18 patients who received the treatment of titanium mesh cage with self-locked titanium plate from September 2004 to June 2007 were retrospectively analyzed, including 11 males and 7 females (aged 32-75 years, 54 years on average). The course of disease was 6 months to 15 years (5.8 years on average). Sixteen patients suffered sensory dysfunction in limbs. Concerning the muscle strength of extremities, 3 cases were on the second level, 12 were on the third level, 1 was on the fourth level, and 2 were on the fifth level. Sixteen cases had pyramidal sign, 13 had retention of urine and feces, 8 had sexual dysfunction, and 7 combined with symptoms of nerve root type. Twelve cases were consecutive multilevel and 6 cases were discontinuous multilevel. The mean JOA scores were 8.30 +/- 1.21 preoperatively. X-ray films and MRI showed degeneration and protrusion of intervertebral disc and compression of cervical cord preoperatively. The height of involved intervertebral space was (6.40 +/- 0.87) mm on X-ray films preoperatively.

All the incisions were healed by first intention. All the patients were followed up for 6-36 months (18 months on average). The recovery of extremities motor function was better than that of sensory function at the early stage after operation. Muscular tension decreased after operation and mobility of limbs was improved. The operated segments were instantly stable and solid fusion was observed at 3-6 months after operation. JOA scores at 6 months after operation was 12.60 +/- 0.78 with an improvement rate of 51.8%, indicating significant difference was evident when compared with the JOA scores before operation (P < 0.05). The height of involved intervertebral space increased significantly to (8.20 +/- 0.46) mm postoperatively, indicating the difference was significant (P < 0.05). According to Odom's evaluation scale, 17 patients were graded as excellent and 1 as good. No death and complications of spinal cord, nerve, trachea and esophagus were observed. The cage witnessed no translocation.

Titanium mesh cage with self-locked titanium plate is more stable and effective for the treatment of multilevel cervical intervertebral disc protrusion.