Clinical efficacy of 3D printed microporous titanium artificial vertebral body in treatment of ossification of cervical posterior longitudinal ligament

Abstract

Objective To observe the clinical efficacy of 3D printed microporous titanium artificial vertebral body in the treatment of ossification of posterior longitudinal ligament (OPLL). Methods The clinical data of 64 patients with OPLL who underwent anterior subtotal vertebral resection and decompression followed by 3D printed microporous titanium artificial vertebral body or titanium mesh cage implantation and titanium plate internal fixation in our department from January of 2018 to January of 2020 were collected and retrospectively analyzed. Finally, only 57 cases meeting the inclusion and exclusion criteria were recruited. According to different implants, they were divided into observation group (n=28, of 3D printed microporous titanium artificial vertebral body) and control group (n=29, titanium mesh cage). The operation time, intraoperative blood loss, Japanese Orthopaedic Association (JOA) score and improvement rate, as well as incidence of prosthesis settlement and bone graft fusion were compared between the 2 groups. Results The operation time and intraoperative blood loss in the treatment group were 59.32±12.09 min and 102.75±11.25 mL respectively, while those in the control group was 67.55±4.71 min and 102.06±13.83 mL respectively. The operation time was significantly shorter in the observation group than the control group (P=0.001), but there was no statistical difference in intraoperative blood loss between them. During the follow-up time from 12 to 15 (14.3±2.7) months, 1 case (control group) complicated with wound infection, and 7 cases (3 cases in the treatment group and 4 cases in the control group) complicated with neck swallowing discomfort, which disappeared in 1~2 weeks later. All patients were bone healing at the last follow-up, and no fracture or malposition of implants were seen in all patients. At the last follow-up, the treatment group had a JOA score increased from 11.61±0.99 to 16.10±0.68, and an improvement rate of (83.03±12.68)%, and that in the control group was elevated from 11.37±1.08 to 16.03±0.56, and an improvement rate was (81.58±12.67)%. However, there was no significant difference in the improvement rate between the 2 groups. Significant difference was seen in prosthesis settlement between the treatment group (1 case, 3.57%) and the control group (12 cases, 41.38%, P=0.001). Conclusion 3D printed microporous titanium artificial vertebral body can reconstruct the stability of cervical spine, with the advantages of better bone material interface, faster installation, and less prosthesis sinking when compared with titanium mesh cage.

Keywords

• cervical spine
• ossification of posterior longitudinal ligament
• 3d printed microporous titanium artificial vertebral body
• titanium mesh cage