Myth or Fact: 3D-printed off-the-shelf prosthesis is superior to Titanium mesh cage in anterior cervical corpectomy and fusion

Abstract

Abstract Objective To find out if 3DP OTS prosthesis is superior to TMC in ACCF when treating single-segment DCSM. Methods DCSM patients underwent ACCF from January 2016 to January 2019 in a single center were included. Patients were divided into the 3DP group (28) and the TMC group (23). The hospital stays, operation time, intraoperative blood loss, and the cost of hospitalization were compared. The JOA scores and NDI were recorded pre-operatively, 1 day, 3, 6, 12, and 24 months post-operatively. Radiological data was measured to evaluate fusion, subsidence, and cervical lordosis. Patients were sent with SF-36 to assess their HRQoL. Results The differences in operative time, intraoperative blood loss, and hospital stay were not statistically significant between groups (p>0.05). Postoperative dysphagia occurred in 2 cases in the 3DP group and 3 cases in the TMC group, which all relieved one week later. The difference in improvement of JOA and NDI between the two groups was not statistically significant (p>0.05). No hardware failure was found and bony fusion was achieved in all cases except one in the 3DP group. The difference in CL, FSA, MVH, and subsidence rates between groups at each follow-up time point was not statistically significant and the results of the SF-36 were similar (p>0.05). The total cost was higher in the 3DP group with its higher graft cost (p<0.05). Conclusion In treating single-segment DCSM with ACCF, both 3DP OTS prosthesis and TMC achieved satisfactory outcomes. However, the more costly 3DP OTS prosthesis was not able to reduce subsidence as it claimed.