Feasibility of Non-window Three-Dimensional– Printed Porous Titanium Cage in Posterior Lumbar Interbody Fusion: A Pilot Trialopen access
- Authors
- Ham, Dae-Woong; Jung, Chan-Woo; Chang, Dong-Gune; Yang, Jae Jun; Song, Kwang-Sup
- Issue Date
- Dec-2023
- Publisher
- Korean Orthopaedic Association
- Keywords
- Lumbar surgery; Ossteointegration; Printing; Spinal fusion; Titanium
- Citation
- CiOS Clinics in Orthopedic Surgery, v.15, no.6, pp 960 - 967
- Pages
- 8
- Journal Title
- CiOS Clinics in Orthopedic Surgery
- Volume
- 15
- Number
- 6
- Start Page
- 960
- End Page
- 967
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/70657
- DOI
- 10.4055/cios22404
- ISSN
- 2005-291x
2005-4408
- Abstract
- Background: The commercially available design of a three-dimensional (3D)–printed titanium (3D-Ti) cage can be divided into two types according to the presence of a window: a cage with a window that allows filling of bone graft materials and a non-window cage for stand-alone use. This prospective observational case series study aimed to explore the clinical feasibility of using a non-window type 3D-Ti cage in cases of combined window and non-window cage implantation. Furthermore, we evaluated the bone in growth patterns of non-window cages and their correlation with published fusion grading systems. Methods: A total of 31 consecutive patients who underwent single-level posterior lumbar interbody fusion surgery were included. Two 3D-Ti cages with different designs were inserted: a non-window cage on the left side and a window cage on the right side. Radiographic fusion was defined by the segmental angle between flexion and extension radiographs (F-E angle) and cage bridging bone (CBB) scores on computed tomography. The association between the F-E angle and osteointegration scoring system including the surface osteointegration ratio (SOR) score was analyzed. Results: Radiographic fusion was achieved in 27 of 31 patients (87%) at 12 months postoperatively. Among the non-window cages, 23 of 31 (74.2%) had fair SOR scores, while 19 of 31 (61.3%) window cages had fair intra-cage CBB scores. The higher the SOR score was, the smaller the flexion-extension angle (SOR 0 vs. SOR 1: 6.30° ± 2.43° vs. 1.95° ± 0.99°, p < 0.001; SOR 0 vs. SOR 2: 6.03° ± 2.43° vs. 0.99°± 0.74°, p < 0.001). Conclusions: The clinical feasibility of using a non-window 3D-Ti cage during lumbar interbody fusion might be acceptable. Fur-thermore, a newly suggested fusion criterion for the use of the non-window cage, the SOR score, showed a significant association with the published fusion grading systems, demonstrating its feasibility in determining interbody fusion in lumbar spinal surgery. © 2023 by The Korean Orthopaedic Association.
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