Comparison of early clinical efficacy of 3D-printed vertebral body and nano hydroxyapatite/polyamide 66 strut in anterior cervical corpectomy and fusion
Objective To compare the cervical sagittal balance and clinical effect between 3D-printed vertebral body and nano hydroxyapatite/polyamide 66(n-HA/PA66)strut after anterior cervical corpectomy and fusion(ACCF).Methods A retrospective analysis was performed on 56 patients who un-derwent ACCF in First Affiliated Hospital of Zhengzhou University from June 2020 to January 2022.Among them,28 patients underwent 3D printed vertebral body fusion(3D group).A total of 28 patients underwent n-HA/PA66 strut fusion(n-HA/PA66 group).Preoperative general data,postoperative clinical and radio-logical parameters of the two groups were analyzed.Results C2-7 Cobb in 3D group was higher than that in n-HA/PA66 group at 3,6,12 and 18 months after surgery(19.42±3.20 vs.17.71±2.50,18.71± 3.15 vs.17.04±1.94,18.49±3.13 vs.16.86±2.17,18.32±2.89 vs.16.40±1.48,t=-2.233,-2.385,-2.267,-3.121,P<0.05).C2-7SVA in 3D group was lower than that in n-HA/PA66 group at 3,6,12 and 18 months after surgery(14.52±2.45 vs.16.88±2.50,14.74±2.21 vs.17.30±3.86,14.81±2.28 vs.17.38±3.91,15.27±2.23 vs.17.84±3.76,t=2.595,3.052,3.004,3.107,P<0.05).The inclination of T1 in 3D group was higher than that in n-HA/PA66 group at 3,6,12 and 18 months after surgery(24.11±2.88 vs.21.47±2.11,23.15±2.67 vs.20.46±2.02,23.23±2.70 vs.20.64±2.08,22.58±2.44 vs.20.04±2.02,t=-3.912,-4.257,-4.011,-4.253,P<0.05).The fusion rate at 3rd month after surgery in the 3D group was higher than that in the n-HA/PA66 group[82.1%(46/56)vs.65.5%(36/56),x2=4.004,P<0.05].The subsidence rate at 12,18 months after surgery in the 3D group was lower than that in the n-HA/PA66 group[5.4%(3/56)vs.21.4%(12/56),7.1%(4/56)vs.25.0%(14/56),x2=6.235,6.619,P<0.05].Conclusion Both 3D printed vertebrae and n-HA/PA66 strut can achieve good early clinical results in ACCF,but 3D printed vertebrae have more advantages in interbody fusion speed,maintaining physiological curvature and slowing down settlement.