Factors influencing cage subsidence in anterior cervical corpectomy and discectomy: a systematic review.

Autor: Dhar UK; Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL, USA., Menzer EL; Department of Biological Sciences, Florida Atlantic University, Boca Raton, FL, USA., Lin M; Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL, USA., Hagerty V; Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA., O'Connor T; Department of Neurosurgery, Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, FL, USA., Tsai CT; Department of Ocean and Mechanical Engineering, Florida Atlantic University, Boca Raton, FL, USA., Vrionis FD; Department of Neurosurgery, Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, FL, USA. FVrionis@baptisthealth.net.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2023 Mar; Vol. 32 (3), pp. 957-968. Date of Electronic Publication: 2023 Jan 28.
DOI: 10.1007/s00586-023-07530-w
Abstrakt: Purpose: Various factors have been examined in relation to cage subsidence risk, including cage material, cage geometry, bone mineral density, device type, surgical level, bone graft, and patient age. The present study aims to compare and synthesize the literature of both clinical and biomechanical studies to evaluate and present the factors associated with cage subsidence.
Methods: A comprehensive search of the literature from January 2003 to December 2021 was conducted using the PubMed and ScienceDirect databases by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Following the screening for inclusion and exclusion criteria, a total of 49 clinical studies were included. Correlations between clinical and biomechanical studies are also discussed.
Results: Patients treated with the cage and plate combination had a lower subsidence rate than patients with the stand-alone cage. Overall, Polyetheretherketone material was shown to have a lower subsidence rate than titanium and other materials. The subsidence rate was also higher when the surgery was performed at levels C5-C7 than at levels C2-C5. No significant correlation was found between age and cage subsidence clinically.
Conclusions: Cage subsidence increases the stress on the anterior fixation system and may cause biomechanical instability. Severe cage subsidence decreases the Cobb angle and intervertebral height, which may cause destabilization of the implant system, such as screw/plate loosening or breakage of the screw/plate. Various factors have been shown to influence the risk of cage subsidence. Examining clinical research alongside biomechanical studies offers a more comprehensive understanding of the subject.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE