The most appropriate titanium mesh cage size for anterior sp
The aim of this study was thus to determine the most appropriate titanium mesh cage diameter for reconstruction after spondylectomy.

A finite element model of the single level lumbar TES was created. 6 models of titanium mesh cage with diameters of 1/3, 1/2, 2/3, 3/4, 4/5 of the caudad adjacent vertebra, and 1/1 of the cephalad vertebra were tested for construct stiffness. The peak von Mises stress (MPa) at the failure point and the site of failure were measured as outcomes. A cadaveric validation study also conducted to validate the finite element model.

Results:
--For axial loading, the maximum stress points were at the titanium mesh cage, with maximum stress of 44,598 MPa, 23,505 MPa, 23,778 MPa, and 16,598 MPa, 10,172 MPa, 10,805 MPa in the 1/3, 1/2, 2/3, 3/4, 4/5, and 1/1 diameter model, respectively.

--For torsional load, the maximum stress point in each of the cages was identified at the rod area of the spondylectomy site, with maximum stress of 390.9 MPa, 141.35 MPa, 70.098 MPa, and 88.972 MPa, 42.249 MPa, 15.827 MPa, respectively.

--A cadaveric validation study results were coincided with the finite element model results.

Finally, due to its ability to withstand both axial and torsional tension, the mesh cage diameter for reconstruction should be 1/1 the diameter of the lower endplate of the adjacent cephalad vertebra. In terms of withstanding stress, a cage diameter of more than half of the upper endplate of the caudad vertebrae is appropriate due to the complexity of large size cage insertion. After complete en bloc spondylectomy, a cage diameter of 1/3 is insufficient for reconstruction

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02326-4
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