Subsidence of titanium mesh cage: a study based on 300 cases

Area of Science:

• Spine surgery
• Orthopedic oncology
• Biomaterials in medicine

Background:

• Anterior cervical corpectomy with titanium mesh cage (TMC) fusion is a common treatment for cervical degenerative diseases.
• Postoperative subsidence of the TMC is a frequently reported complication.
• Understanding risk factors for TMC subsidence is crucial for improving patient outcomes.

Purpose of the Study:

• To identify risk factors for titanium mesh cage (TMC) subsidence following anterior cervical corpectomy and fusion.
• To analyze the clinical correlations of TMC subsidence.
• To evaluate the impact of corpectomy level on TMC subsidence.

Main Methods:

• A cohort study involving 300 patients undergoing anterior cervical corpectomy and TMC fusion.
• Patients were categorized by 1-level (n=236) or 2-level (n=64) corpectomy.
• Evaluation included TMC subsidence, radiologic findings, and clinical results over a 12-month follow-up.

Main Results:

• TMC subsidence occurred in 79.7% of cases (mild in 60.7%, severe in 19.0%).
• Two-level corpectomy was significantly associated with severe subsidence (P<0.001).
• Severe subsidence correlated with lower Japanese Orthopedic Association recovery rates and increased subsidence-related complications.

Conclusions:

• Titanium mesh cage (TMC) subsidence is a prevalent complication after anterior cervical corpectomy and fusion.
• The level of corpectomy is a significant risk factor for severe TMC subsidence.
• Severe subsidence is linked to adverse clinical outcomes and complications, including neck pain and neurologic deterioration.