TIPS, TRICKS ABOUT TITANIUM MESH CAGES

A titanium mesh cage provides a biomechanical stability for the anterior thoracic arthrodesis.

KEY PRINCIPLES:

A cylindrical mesh cage like Harms' cage provides biomechanical stability with bony ingrowth potential. Fenestrations in the cage incease the graft-host bony surface area for maximal bony graft incorporation.

INDICATIONS:
All anterrior spinal pathologies involving decompressive procedures.

CONTRA-INDICATIONS:
pyogenic infections of spine- avoid metallic implants anteriorly; post. implants can be us

TIPS/ TRICKS:

Place the cage as posteriorly as possible near the middle column.

Use the harvested rib graft for packing the inside of the cage.

Preserve the subchondral bony end plates.

The ends of the cage can be trimmed to achieve desired cage configuration.

Internal rings can be fitted at the neds of the cage whicj increas the stability of the cage.

The serrated border increase the anchoring of the cage.

The bone graft should be packed around the cage.

A single anterior rod construct increase stability of cage.

Large ant. defects need post. column support.

PMMA is an alternative to the cage.