Key Takeaways & Executive Findings
- •• 3D-printed artificial vertebral bodies significantly reduce operation time compared to traditional titanium cages in anterior cervical corpectomy and fusion. • They better maintain intervertebral disc height at last follow-up, reducing the risk of subsidence. • Postoperative dysphagia incidence is lower with 3D-printed artificial vertebral bodies. • No significant differences were found in blood loss, hospital stay, neurological recovery, or fusion rate.
Abstract
OBJECTIVE: In recent years, many scholars have applied 3D-printed artificial vertebrae to anterior cervical vertebral subtotal vertebral resection and bone grafting fusion, but whether it is more effective than traditional titanium cages remains controversial. This study aims to systematically evaluate the effectiveness and safety of 3D-printed artificial vertebrae compared with traditional titanium cages as implants for anterior cervical corpectomy and fusion in the treatment of spondylosis. METHODS: Databases such as CNKI, WangFang, CBM, VIP, PubMed, EMBASE, and The Cochrane Library were searched to collect the clinical research on the application of 3D-printed artificial vertebrae in anterior cervical corpectomy and fusion from the establishment of each database to February 2025. After screening the literature, extracting the data and evaluating the methodological quality of the included studies, the meta-analysis was performed using Rev Man 5.4 software. RESULTS: A total of 10 studies were included, comprising 2 prospective randomized controlled studies, 6 retrospective cohort studies, and 2 prospective cohort studies, all of high quality. The included studies involved 534 patients, with 273 in the 3D-printed group and 261 in the control group. Meta-analysis results showed that the 3D-printed group was superior to the control group in terms of operation time [SMD=-1.13, 95%CI(-1.87, -0.39), P=0.003], loss of intervertebral disc height at last follow-up [SMD=-3.01, 95%CI(-5.74, -0.29), P=0.03], neck disability index at 3 months postoperatively [SMD=-0.34, 95%CI(-0.66, -0.03), P=0.03], prosthesis subsidence rate [OR=0.19, 95%CI(0.11, 0.32), P < 0.000 01], and postoperative dysphagia incidence [OR=0.43, 95%CI(0.21, 0.90), P=0.03], with significant differences. There were no significant differences in blood loss, hospital stay, postoperative Japanese Orthopaedic Association score, postoperative visual analogue scale score, postoperative neck disability index (at 6 months and last follow-up), and fusion rate between the two groups (P > 0.05). CONCLUSION: Compared with traditional titanium cages, 3D-printed artificial vertebral bodies have significant advantages in improving surgical efficiency, maintaining postoperative intervertebral disc height, reducing postoperative dysphagia incidence, and reducing prosthesis subsidence rate.
1. Introduction
Anterior cervical corpectomy and fusion (ACCF) is a common surgical procedure for treating cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament, as it effectively decompresses the spinal cord from anterior compression [1]. Traditional titanium mesh cages are frequently used in ACCF due to their good biocompatibility, adjustable height, and strong support [2-3]. However, postoperative cage subsidence is a notable complication that may lead to catastrophic outcomes [4-5].
In recent years, advances in 3D printing technology, materials science, and engineering have introduced 3D-printed artificial vertebral bodies as a novel option for patients undergoing ACCF [6-7]. Some studies have reported the safety and efficacy of 3D-printed artificial vertebral bodies in ACCF, but most have small sample sizes and weak evidence. Therefore, this meta-analysis aims to compare the efficacy and safety of traditional titanium mesh cages and 3D-printed artificial vertebral bodies in ACCF to guide clinical practice.
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WU Ronghai, ZHENG Zhouhang, CHEN Huan, YOU Dongchun, GUO Weifeng, LIU Xingming, ZHANG Yu (2026). Meta-analysis of application effect of 3D-printed artificial vertebral bodies in anterior cervical corpectomy and fusion. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21428
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Frequently Asked Questions
What is the main advantage of 3D-printed artificial vertebral bodies over traditional titanium cages in ACCF?
3D-printed artificial vertebral bodies significantly reduce operation time, better maintain intervertebral disc height, and lower the incidence of postoperative dysphagia and prosthesis subsidence compared to traditional titanium cages.
Are there any significant differences in fusion rates between 3D-printed artificial vertebral bodies and titanium cages?
No significant differences were found in fusion rates between the two groups, indicating comparable effectiveness in achieving bony fusion.
What are the potential complications associated with 3D-printed artificial vertebral bodies?
The meta-analysis found that 3D-printed artificial vertebral bodies have a lower risk of prosthesis subsidence and postoperative dysphagia, but other complications such as infection or neurological deficits were not specifically addressed.
Is 3D-printed artificial vertebral body suitable for all patients undergoing ACCF?
While 3D-printed artificial vertebral bodies show advantages, patient selection should consider individual anatomy, pathology, and surgeon expertise. Further research is needed to establish specific indications.
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