Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients
Abstract Background The 3D-printed artificial vertebral body (AVB) was designed with theoretically better biomechanical properties than traditional implants to decrease the incidence of implant subsidence. However, implant subsidence still occurs, with the potential risk factors for AVB subsidence r...
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| Language: | English |
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BMC
2025-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-06056-9 |
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| author | Qu Ruomu Wang Haoxiang Xia Tian Geng Hanbo Zhao Yanbin Diao Yinze Chen Xin Pan Shengfa Zhang Li Wang Shaobo Zhang Fengshan Sun Yu Liu Zhong jun Zhou Feifei |
| author_facet | Qu Ruomu Wang Haoxiang Xia Tian Geng Hanbo Zhao Yanbin Diao Yinze Chen Xin Pan Shengfa Zhang Li Wang Shaobo Zhang Fengshan Sun Yu Liu Zhong jun Zhou Feifei |
| author_sort | Qu Ruomu |
| collection | DOAJ |
| description | Abstract Background The 3D-printed artificial vertebral body (AVB) was designed with theoretically better biomechanical properties than traditional implants to decrease the incidence of implant subsidence. However, implant subsidence still occurs, with the potential risk factors for AVB subsidence remaining unknown. This study aimed to identify the risk factors for early subsidence of AVB after single-level anterior cervical corpectomy and fusion (ACCF). Methods Consecutive patients who underwent single-level ACCF using 3D-printed AVB for cervical spondylotic myelopathy between 2018 and 2022 were included. Preoperative, immediate postoperative, and 3-month postoperative X-ray scans were evaluated. Radiological assessment included segmental height (SH), intraoperative retraction height, cervical alignment parameters, bone quality and implant sagittal size ratio. Early subsidence was defined as an SH loss ≥ 2 mm based on 3-month radiographs. Results Of the included 98 patients (52 males, 46 females, average age: 51.8 ± 10.1), 35(35.7%) experienced early subsidence. The subsidence group exhibited significantly higher age, segmental sagittal vertical axis, cervical lordosis, C7 slope, and segmental slope, alongside lower implant sagittal size ratio. Correlation analysis revealed that SH loss is significantly positively correlated with intraoperative retraction height, segmental SVA, C7 slope, segmental slope, and negatively with the ratio of implant sagittal diameter compared to vertebra. Forward multivariable logistic regression indicated that greater age (p = 0.029), intraoperative retraction height (p < 0.001), and segmental slope (p = 0.006) were significant risk factors, while a higher implant sagittal size ratio (p = 0.004) was a protective factor against AVB subsidence. Conclusions Increased age, segmental slope, intraoperative retraction height, and a lower implant sagittal size ratio are significant risk factors for AVB subsidence. Surgeons should consider these factors in surgery planning and avoid excessive intraoperative retraction. |
| format | Article |
| id | doaj-art-b58c982b79fc4ced8b8d8db48c096fa6 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-b58c982b79fc4ced8b8d8db48c096fa62025-08-20T03:42:52ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-012011910.1186/s13018-025-06056-9Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patientsQu Ruomu0Wang Haoxiang1Xia Tian2Geng Hanbo3Zhao Yanbin4Diao Yinze5Chen Xin6Pan Shengfa7Zhang Li8Wang Shaobo9Zhang Fengshan10Sun Yu11Liu Zhong jun12Zhou Feifei13Orthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalPeking University Health Science CenterOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalOrthopedic Department, Peking University Third HospitalAbstract Background The 3D-printed artificial vertebral body (AVB) was designed with theoretically better biomechanical properties than traditional implants to decrease the incidence of implant subsidence. However, implant subsidence still occurs, with the potential risk factors for AVB subsidence remaining unknown. This study aimed to identify the risk factors for early subsidence of AVB after single-level anterior cervical corpectomy and fusion (ACCF). Methods Consecutive patients who underwent single-level ACCF using 3D-printed AVB for cervical spondylotic myelopathy between 2018 and 2022 were included. Preoperative, immediate postoperative, and 3-month postoperative X-ray scans were evaluated. Radiological assessment included segmental height (SH), intraoperative retraction height, cervical alignment parameters, bone quality and implant sagittal size ratio. Early subsidence was defined as an SH loss ≥ 2 mm based on 3-month radiographs. Results Of the included 98 patients (52 males, 46 females, average age: 51.8 ± 10.1), 35(35.7%) experienced early subsidence. The subsidence group exhibited significantly higher age, segmental sagittal vertical axis, cervical lordosis, C7 slope, and segmental slope, alongside lower implant sagittal size ratio. Correlation analysis revealed that SH loss is significantly positively correlated with intraoperative retraction height, segmental SVA, C7 slope, segmental slope, and negatively with the ratio of implant sagittal diameter compared to vertebra. Forward multivariable logistic regression indicated that greater age (p = 0.029), intraoperative retraction height (p < 0.001), and segmental slope (p = 0.006) were significant risk factors, while a higher implant sagittal size ratio (p = 0.004) was a protective factor against AVB subsidence. Conclusions Increased age, segmental slope, intraoperative retraction height, and a lower implant sagittal size ratio are significant risk factors for AVB subsidence. Surgeons should consider these factors in surgery planning and avoid excessive intraoperative retraction.https://doi.org/10.1186/s13018-025-06056-9Cervical spineImplant subsidenceACCF3D printed artificial vertebral body |
| spellingShingle | Qu Ruomu Wang Haoxiang Xia Tian Geng Hanbo Zhao Yanbin Diao Yinze Chen Xin Pan Shengfa Zhang Li Wang Shaobo Zhang Fengshan Sun Yu Liu Zhong jun Zhou Feifei Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients Journal of Orthopaedic Surgery and Research Cervical spine Implant subsidence ACCF 3D printed artificial vertebral body |
| title | Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients |
| title_full | Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients |
| title_fullStr | Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients |
| title_full_unstemmed | Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients |
| title_short | Risk factors of early subsidence of 3D-printed artificial vertebral body following single-level anterior cervical corpectomy and fusion (ACCF): retrospective study of 98 patients |
| title_sort | risk factors of early subsidence of 3d printed artificial vertebral body following single level anterior cervical corpectomy and fusion accf retrospective study of 98 patients |
| topic | Cervical spine Implant subsidence ACCF 3D printed artificial vertebral body |
| url | https://doi.org/10.1186/s13018-025-06056-9 |
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