Myth or fact: 3D-printed off-the-shelf prosthesis is superior to titanium mesh cage in anterior cervical corpectomy and fusion?

• Published in: BMC musculoskeletal disorders 2024-01, Vol.25 (1), p.96-96, Article 96
• Main Authors: He, Haoyu, Fan, Lei, Lü, Guohua, Li, Xinyi, Li, Yunchao, Zhang, Ou, Chen, Zejun, Yuan, Hui, Pan, Changyu, Wang, Xiaoxiao, Kuang, Lei
• Format: Article
• Language: English
• Subjects: 3D printing; 3D-printed prosthesis; Anterior cervical corpectomy and fusion; Artificial Limbs; Back surgery; Blood Loss, Surgical; Care and treatment; Central nervous system diseases; Cervical spondylotic myelopathy; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Comparative analysis; Cost-effectiveness; Design and construction; Dysphagia; Humans; Lordosis - surgery; Orthopedic implants; Patients; Printing, Three-Dimensional; Prostheses; Quality of Life; Retrospective Studies; Spinal cord; Spinal cord compression; Spinal Cord Diseases - surgery; Spinal Fusion - adverse effects; Spinal Fusion - methods; Spine; Spondylosis - diagnostic imaging; Spondylosis - surgery; Statistical analysis; Subsidence; Surgery; Surgical Mesh; Titanium; Transplants & implants; Treatment Outcome; Vertebrae
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07213-7

To find out if three-dimensional printing (3DP) off-the-shelf (OTS) prosthesis is superior to titanium mesh cages in anterior cervical corpectomy and fusion (ACCF) when treating single-segment degenerative cervical spondylotic myelopathy (DCSM). DCSM patients underwent ACCF from January 2016 to January 2019 in a single center were included. Patients were divided into the 3DP group (28) and the TMC group (23). The hospital stays, operation time, intraoperative blood loss, and the cost of hospitalization were compared. The Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI) were recorded pre-operatively, 1 day, 3, 6, 12, and 24 months post-operatively. Radiological data was measured to evaluate fusion, subsidence, and cervical lordosis. Patients were sent with SF-36 to assess their health-related quality of life (HRQoL). The differences in operative time, intraoperative blood loss, and hospital stay were not statistically significant between groups (p > 0.05). Postoperative dysphagia occurred in 2 cases in the 3DP group and 3 cases in the TMC group, which all relieved one week later. The difference in improvement of JOA and NDI between the two groups was not statistically significant (p > 0.05). No hardware failure was found and bony fusion was achieved in all cases except one in the 3DP group. The difference in cervical lordosis (CL), fused segmental angle (FSA), mean vertebral height (MVH), and subsidence rates between groups at each follow-up time point was not statistically significant and the results of the SF-36 were similar (p > 0.05). The total cost was higher in the 3DP group with its higher graft cost (p