Bowen Hu1, Linnan Wang1, Yueming Song1, Yujie Hu1, Qiunan Lyu1, Limin Liu1, Ce Zhu1, Chunguang Zhou1, Xi Yang2. 1. Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. 2. Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China. Electronic address: formosa88@163.com.
Abstract
OBJECTIVES: The nanohydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel biomimetic nonmetal cage device that is now used in some medical centers, while the titanium mesh cage (TMC) is a typical metal cage device that has been widely used for decades. This study was performed to compare the long-term outcomes of these two different cages in patients undergoing anterior cervical corpectomy. PATIENTS AND METHODS: This retrospective study involved 107 patients who underwent single-level anterior corpectomy using either a TMC (n = 52) or an n-HA/PA66 cage (n = 55) for treatment of cervical degenerative disease with a minimum follow-up of 8 years. Their radiographic data (cage subsidence, fusion status, segmental sagittal alignment, and cervical spine degeneration) and clinical data [visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scores] were evaluated preoperatively, postoperatively, and at the final follow-up. RESULTS: The mean duration of follow-up was 103.6 ± 6.3 months in the n-HA/PA66 group and 102.4 ± 4.6 months in the TMC group. The n-HA/PA66 group and the TMC group had similar final fusion rates (97% vs. 94%, respectively). The final n-HA/PA66 cage subsidence was 2.4 ± 1.0 mm with 18.2% subsidence of >3 mm, which was significantly lower than the respective 3.0 ± 0.7 mm and 40.4% for the TMC (p < 0.01). The n-HA/PA66 group also had better JOA scores than the TMC group (p < 0.01). No significant difference in the segmental sagittal alignment, cervical lordosis, or VAS score was observed between the two groups (p = 0.18, 0.42, and 0.17, respectively). CONCLUSIONS: The n-HA/PA66 cage is associated with excellent radiographic fusion, lower subsidence and better clinical outcomes than the TMC within 8 years after single-level anterior cervical corpectomy. With the addtional benefit of radiolucency, the n-HA/PA66 cage could be superior to the TMC in anterior cervical construction.
OBJECTIVES: The nanohydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel biomimetic nonmetal cage device that is now used in some medical centers, while the titanium mesh cage (TMC) is a typical metal cage device that has been widely used for decades. This study was performed to compare the long-term outcomes of these two different cages in patients undergoing anterior cervical corpectomy. PATIENTS AND METHODS: This retrospective study involved 107 patients who underwent single-level anterior corpectomy using either a TMC (n = 52) or an n-HA/PA66 cage (n = 55) for treatment of cervical degenerative disease with a minimum follow-up of 8 years. Their radiographic data (cage subsidence, fusion status, segmental sagittal alignment, and cervical spine degeneration) and clinical data [visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scores] were evaluated preoperatively, postoperatively, and at the final follow-up. RESULTS: The mean duration of follow-up was 103.6 ± 6.3 months in the n-HA/PA66 group and 102.4 ± 4.6 months in the TMC group. The n-HA/PA66 group and the TMC group had similar final fusion rates (97% vs. 94%, respectively). The final n-HA/PA66 cage subsidence was 2.4 ± 1.0 mm with 18.2% subsidence of >3 mm, which was significantly lower than the respective 3.0 ± 0.7 mm and 40.4% for the TMC (p < 0.01). The n-HA/PA66 group also had better JOA scores than the TMC group (p < 0.01). No significant difference in the segmental sagittal alignment, cervical lordosis, or VAS score was observed between the two groups (p = 0.18, 0.42, and 0.17, respectively). CONCLUSIONS: The n-HA/PA66 cage is associated with excellent radiographic fusion, lower subsidence and better clinical outcomes than the TMC within 8 years after single-level anterior cervical corpectomy. With the addtional benefit of radiolucency, the n-HA/PA66 cage could be superior to the TMC in anterior cervical construction.