Radiological and Clinical Outcomes after Anterior Cervical Discectomy and Fusion (ACDF) with an Innovative 3D Printed Cellular Titanium Cage Filled with Vertebral Bone Marrow

• Published in: BioMed research international Vol. 2022; pp. 6339910 - 8
• Main Authors: Mayer, Frizzi, Heider, Franziska, Haasters, Florian, Mehren, Christoph
• Format: Journal Article
• Language: English
• Published: United States Hindawi 2022; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: 3D printing; Biomedical research; Bone marrow; Cages; Clinical outcomes; Discectomy; Equipment and supplies; Materials; Orthopedic equipment and supplies; Osteoporosis; Pain; Patient outcomes; Patient satisfaction; Patients; Plating; Production processes; Software; Spinal fusion; Spinal stenosis; Subsidence; Surgery; Three dimensional printing; Titanium; Titanium products; Transplants & implants; Vertebrae; X-rays; Germany
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2022/6339910

Study Design. Prospective single-center study. Objectives. To assess the clinical and radiological outcomes after ACDF with 3D printed cellular titanium cages filled with bone marrow and to compare the clinical and radiological results with the current scientific literature. Methods. ACDF was performed monosegmentally under standardized conditions. X-rays were analyzed to determine the range of motion, fusion rates, and subsidence preoperatively and 3 and 12 months postoperatively. Clinical outcome measurements included neck disability index (NDI), visual analogue scale (VAS) for brachialgia and cervicalgia, and patient satisfaction. Results. 18 patients were included in the study. The mean RoM decreased from 7.7°±2.6 preoperatively to 1.7°±1.1° after 3 months and 1.8°±1.2° 12 months after surgery. The fusion rates were at 94.4% after 3 and 12 months. The mean subsidence was 0.9 mm±0.5 mm 3 months postoperatively and 1.1 mm±0.5 mm 12 months after surgery. The mean NDI improved significantly from preoperatively to 12 months postoperatively (34.6±6.2 and 3.4±4.1, respectively). The VAS-neck also showed a large improvement from 5.8±2.2 before and 1.3±1.4 12 months after surgery, as did the VAS-arm (6.4±1.5 and 0.9±1.6, respectively). Patient satisfaction was high throughout the follow-up period. Conclusion. ACDF with a 3D printed titanium cage resulted in fast fusion without pathological subsidence. In comparison to other cage materials such as PEEK, the 3D printed titanium cage was noninferior in regard to its fusion rate and clinical results.