Titanium Cage in Comparison with Nano-Hydroxyapatite Bone Graft Substitutes in Cervical Reconstruction

Cervical spondylosis is a disease that occurs with age and affects the discs and joints in the cervical spine located in the neck. The hydroxyapatite (HA) bone graft substitutes can used as a potential bone-forming agent, however, the efficacy of using HA is challenging in cervical reconstruction. In this regard, nano-based HA was used in this study to explore its sagittal parameters and clinical potency in relative to titanium (TiO₂) cage in patient with cervical spondylosis. 50 patients suffering from cervical spondylosis were divided in two groups and were grafted with either TiO₂ cage or nano-HA. The sagittal parameters, including cervical spine lateral radiographs (C_0-2Coob and C_2-7Coob) were taken pre- and post-operation (3-month, one-year and two-year). The clinical potency was also done based on the JOA scores. Angle analysis indicated that the C_0-2Cobb and C_2-7Cobb angles were significantly changed after the operation in both TiO₂ cage and nano-HA groups, whereas no significant changes was determined in nano-HA relative to TiO₂ cage condition. Also, it was shown that JOA scores were significantly higher after the operation than pre-operation, indicating a potential cervical reconstruction after surgery in both groups which slightly were higher for nano-HA groups.