Article Figures & Data
Figures
- Figure 1
(A) Implant subsidence was assessed on lateral radiographs at the cranial and the caudal end plates of the upper and the lower vertebrae in the affected segment. The distance between the upper end plate of the upper vertebral body and the lower end plate of the lower vertebral body was measured at the anterior and the posterior points of the end plate. Severe subsidence was defined as a loss of height of >3 mm. (B) Segmental sagittal alignment was defined as the angle between the cranial and the caudal end plates of the upper and the lower vertebrae in the affected segment. (C) Cervical lordosis was measured using Cobb angle from C1 to C7. A, anterior segment height; P, posterior segment height.
- Figure 2
(A) A 48-year-old man who underwent a 2-level corpectomy of C5 and C6 with fusion from C4 to C7. (B) Immediate postoperative lateral radiograph at 24 h. (C) Postoperative lateral radiograph at 3 months showing mild subsidence of the tantalum trabecular metal (TTM) implant into the C4 vertebral body. (D) Postoperative lateral radiograph at 6 months showing no further subsidence of the TTM implant. (E and F) Flexion and extension postoperative lateral radiograph at 12 months demonstrates stable positioning of the TTM implant. (G) Postoperative lateral radiograph at 2 years confirms stable and satisfactory placement of the TTM implant. (H) Postoperative lateral radiograph at 5 years with preserved alignment and placement.
- Figure 3
A 59-year-old woman who underwent 1-level corpectomy of C6. (A) Postoperative lateral radiograph at 3 months showing parallel contact between the vertebral end plate and the tantalum trabecular metal (TTM) implant (lordotic vertebral end plates with lordotic implant surfaces) maximizing the contact surface area between the implant and the vertebral end plate. Note the difficulties encountered in adapting the anterior cervical plate to the shape of the anterior wall of the vertebral body due to significant degenerative changes. (B) Postoperative lateral radiograph at 3 years showing mild subsidence of the TTM implant into the C5 vertebral body and confirming stable and satisfactory placement of the implant.
- Figure 4
A 41-year-old man who underwent 1-level corpectomy of C6. (A) Immediate postoperative lateral radiograph at 2 weeks showing incongruity between the vertebral end plate and the tantalum trabecular metal (TTM) implant (kyphotic degenerative cranial vertebral end plate and lordotic implant). (B and C) Postoperative lateral radiograph at 3 and 6 months showing progressive subsidence of the TTM implant into the C5 and C7 vertebral body. (D) Postoperative lateral radiograph at 1 year showing no further subsidence of the TTM implant. (E) Postoperative lateral radiograph at 3 years showing solid fusion (no radiolucency in the perimeter surrounding the TTM implant) with preserved alignment and placement.
Tables
Characteristic Finding Age, y, mean (range) 50.96 (29–76) Sex, % (n) Female 43.39 (23) Male 56.61 (30) Duration of symptoms, mo, mean (range) 21.68 (4–48) Diagnosis, % (n) Herniated disc 41.51 (22) Spondylosis 58.49 (31) Follow-up after surgery, y, mean (range) 4.85 (2–9) Number of levels fused, % (n) 1 83.01 (44) C4 4.54 (2) C5 34.09 (15) C6 61.36 (27) Number of levels fused, % (n) 2 19.98 (9) C4-C5 33.33 (3) C5-C6 55.55 (5) C6-C7 11.11 (1) Additional semiconstrained anterior cervical plate, % (n) 77.35 (41) - Table 2
Subsidence occurrence in 53 patients treated with an anterior cervical corpectomy and fusion tantalum implant.
Subsidence, % (n) Additional Semiconstrained Anterior Cervical Plate None Mild Severe With (n = 41) 19.51 (8) 75.6 (31) 4.87 (2) Without (n = 12) 8.33 (1) 50 (6) 41.66 (5) - Table 3
Radiologic follow-up: cervical lordosis of 53 patients treated with an anterior cervical corpectomy and fusion tantalum implant.
Mean ± SD Time C1-C7 Cobb Angle Segmental Cobb Angle Preoperative 39.46 ± 12.52 1.64 ± 5.84 Postoperative 38.39 ± 13.85 5.95 ± 4.23 6 mo 42.18 ± 11.37 3.92 ± 4.55 1 y 44.73 ± 11.93 3.95 ± 5.93 Final follow-up 44.52 ± 12.77 3.62 ± 5.38 Improvement/P value 5.06 ± 8.26/P > 0.05 1.98 ± 6.02/P > 0.05 - Table 4
Clinical outcomes of 53 patients treated with an anterior cervical corpectomy and fusion tantalum implant.
% (n) Outcome Measure Preoperative Postoperative Cervical VAS 7.3 (2.2) 2.6 (2.9) Radicular VAS 5.1 (3.7) 2.5 (2.4) Neck Disability Index 47.8 (21.5) 21.3 (23.4) VAS, visual analog scale.
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