Anterior cervical discectomy and interbody fusion with a dentate titanium cage: An experimental radiological and histopathological study in pigs

Hippokratia 2006, 10(4):171-175

PD Tsitsopoulos, Cha Tsonidis, PPh Tsitsopoulos, AI Mintelis, DA Psalla, AK Desiris
2nd Neurosurgery Dpt, Hippokratio Hospital, Thessoloniki, Greece
Pathology Dpt, Veterinary School of Medicine, Aristotle University, Thessaloniki, Greece
Dpt Surgery, Aristotle Univesrity, Thessaloniki, Greece


Background – Aim: The distraction and stabilization provided by anterior cervical discectomy and fusion contribute to neural decompression and optimize osteogenesis. A new titanium cervical implant with specific properties was applied through an anterior approach in ten pigs. Implant behavior regarding in situ position and related osteogenesis were evaluated. Methods: In this controlled animal study, the progress of fusion and osteogenesis was evaluated after one level cervical interbody fusion with a new titanium cage. Ten pigs underwent anterior cervical discectomy and fusion. No substitutes stimulating osteoblastic activity were used. Plain radiographs were carried out. The animals were euthanised 12 and 14 weeks after the operation respectively. Tissue samples were processed routinely and studied histologically. Results: All pigs survived the surgery. Plain radiographs confirmed implant position. Histological analysis demonstrated fibrous connective tissue formation inside and around the implant which was largely transformed into cartilaginous and osseous tissue. Conclusions: Intervertebral space stabilization remains a parameter of crucial importance for early bone healing after anterior cervical discectomy and fusion. The new titanium alloy cage tested in this experimental study can offer the necessary stabilization for osteogenesis and adequate cervical interbody fusion without the need of growth factors.

Keywords: cervical spine, anterior cervical discectomy, fusion, titanium cage, grafts, osteogenesis, pig model

Correspoding author: Tsitsopoulos PPh, e-mail: