Use of cylindrical titanium mesh and locking plates in anterior cervical fusion - Technical note

After performing anterior cervical corpectomy or discectomy for cervical sp ondolytic myelopathy or radiculopathy: iliac crest bone graft and fibular a uto- or allograft is often used to achieve arthrodesis in the cervical spin e. The purpose of this study was, to evaluate the use of a cylindrical tita nium mesh and locking plate system as an alternative technique in achieving anterior cervical fusion and maintaining lordosis. Hospital records and radiographs of 38 patients who underwent anterior cerv ical discectomies (28 patients) or corpectomies (10 patients) from 1995 to 1997 were reviewed retrospectively. All patients had undergone arthrodesis in which autograft and a cylindrical titanium mesh and anterior locking pla te fixation were used after discectomy or corpectomy. There were 20 men and 18 women (mean age 46.1 years; range 34-72 years). Presenting symptoms inc luded radiculopathy (61%), myelopathy (37%), and neck pain (2%). Preoperati ve and postoperative radiographs were studied, and data were obtained on th e following: overall lordosis or kyphosis of the cervical spine, segmental lordosis or kyphosis at each surgically treated level, and evidence of fusi on. In all of the patients in whom lordosis was present preoperatively, lordosi s was maintained during the follow-up period. The overall fusion rate was 1 00%., The average change in overall lordosis or kyphosis related to the fix ation devices was 1.2 degrees (range 1-5 degrees); the average segmental ch ange was 2.3 degrees (range 0-5 degrees); and the mean follow up was 16 mon ths (range 12-36 months). Anterior cervical fusion with cylindrical titanium mesh and cervical lockin g plate system is an effective method of achieving arthrodesis and maintain ing alignment in the cervical spine. The construct may provide additional l oad-sharing function, and it avoids the use of cadaveric bone or the need f or harvesting tricortical iliac crest autograft.