2023, Vol. 27 ›› Issue (18): 2837-2841

Efficacy of 3D printed microporous titanium fusion device applied to anterior cervical decompression graft fusion and its effects on cervical spine anatomy and stress hormones

Jiang Chengming1, Jiang Sainan2, Tang Ye1, Jiang Lin1   

Abstract: BACKGROUND: 3D printed intervertebral fusion has elastic modulus closer to cancellous bone and vertebral cortical bone, and further analysis of the effect of its clinical application is an important guideline for the reasonable selection of fusion device for cervical spine surgery.  
OBJECTIVE: To investigate the effectiveness of 3D printed microporous titanium fusion in anterior cervical decompression graft fusion and its effects on cervical spine anatomy and stress hormones.
METHODS: Totally 90 patients with cervical spondylotic myelopathy in The First Hospital of Changsha from March 2016 to September 2021 were selected, including 46 males and 44 females, aged (46.85±9.74) years old. They were divided into two groups by the random number table method. Patients in the control group (n=45) received anterior cervical decompression graft fusion with a polyetheretherketone interbody fusion and autogenous bone. Patients in the observation group (n=45) received anterior cervical decompression graft fusion with a 3D printed microporous titanium fusion. One week after the operation, the Japanese Orthopaedic Association Spinal Cord Function Scale was used to evaluate the curative effect. At 3 days and 3 months after the operation, cervical spine X-ray films were taken to record the anatomical indexes of the neck. At 1 and 3 days after operation, venous blood was collected to detect the levels of norepinephrine and cortisol. At 3 months after the operation, the neck disability index and the daily living ability scale were used to evaluate the limb function status of the patients.  
RESULTS AND CONCLUSION: (1) There was no significant difference in the excellent and good rate of clinical efficacy between the two groups (P > 0.05). (2) The height of the fused segment, Cobb angle of the fused segment, and T1 tilt angle of the observation group were higher than those of the control group at 3 months after surgery (P < 0.001). The cortisol and norepinephrine levels of the observation group were lower than those of the control group at 1 and 3 days after surgery (P < 0.001). (3) The cervical dysfunction index of the observation group was lower than that of the control group at 3 months after surgery (P < 0.001). Activity of daily living of the observation group was higher than that of the control group at 3 months after surgery (P < 0.001). (4) It can be seen that 3D printed microporous titanium alloy fusion device applied to anterior cervical decompression and implant fusion achieved good results, which can reduce the stress of the body and improve limb function and have more advantages in maintaining cervical spine anatomy.

Key words: 3D printing, microporous titanium fusion, polyetheretherketone intervertebral fusion, cervical spondylotic myelopathy, anterior cervical decompression and bone fusion, stress hormone, biocompatibility