TITANIUM CAGES PACKED WITH HYDROXYAPATITE WITH COLLAGEN FOR ANTERIOR CERVICAL FUSION - A NOVEL TECHNIQUE

Kotipalli Vishnu Prasad M.S. M. Ch. Proff. & HOD, Department of Neurosurgery, King George Hospital, Andhra Medical College, Andhra Pradesh, Visakhapatnam, India

Introduction
Titanium Cages are available in tubular hollow cylinder forms in 8mm, 13mm and 18mm diameters. Titanium Cages are manufactured by MIDHANI (Mineral Dhatu Nigam, Govt. of India). Clinical application of Hydroxy apatite in the anterior cervical fusion was pioneered by Koyama in JAPAN in 1996. His implants were made with non porous dense material. Adjustablility and configuration was not possible in dense implants. The present day synthetic bone is porous and can be shaped, sized and designed according to the needs. Anterior cervical decompression and fusion is a standard procedure.

Aim of the Study
To study the restoration of physiological disc height, antero posterior alignment, balance and immediate load bearing support. Usage of Hydroxy apatite with collagen as a replacement to auto graft (ILIAC BONEGRAFT) for packing into the hollow of the titanium cages which avoids a second surgical procedure on the patient.

Material and Methods
A series of 50 cases of cervical anterior micro discectomy, osteophyte excision, and thorough decompression of spinal cord and nerve roots and an anterior cervical fusion was done using titanium cages packed with hydroxy apatite with collagen.

Demographics
Nature of Lesion

Results
Titanium Cages restored physiological disc height improved antero posterior balance and provided immediate load bearing support. Neck pain, back pain and radicular pain subsided satisifactorily. Partial ejection of cage occured in one case and promptly readjusted. Individual designing of the titanium cages and packing with hydroxy apatite with collagen has been proved to be an easy, cost effective spine and cervical surgery and safe technique for the anterior cervical fusion procedure. The usage of hydroxy apatite with collagen has avoided possible complications like:
  • Post operative wound pain
  • Meralgia Parasthetica
  • Anesthesia and Discomfort
  • Fracture of ILIAC bone
  • AV Fistulas
  • Visceral Herniation
  • Pelvic Instability
  • Uretheral Injuries

References
  • Neurol Med Chir (Tokyo) 48, 440-446, 2008
  • Acta neurochirugica2000.vol.!42,n4, pp.425-434 (54ref)
  • J Spinal Disord tech. 2005 aug ; 18(4) : 326-31
  • Spine J. 2004 mar-apr; 4 (2): 184-91; discussion 191

Titanium Cages restored physiological disc height improved antero posterior balance and provided immediate load bearing support.

DR. K. VISHNU PRASAD

CNS CONFERENCE 2009

Author: Dr. K. Vishnu Prasad

The Congress of Neurological Surgeons 2009 Annual Meeting features high-impact science and innovative presentations set against the backdrop of America’s most welcoming and exciting cities. Dr. K. Vishnu Prasad's paper was selected for the 2009 Digital Poster Presentation.