Table 3. Outcomes of studies utilizing tantalum in cervical spine surgery.
| Article | Procedure type | VAS pain outcomes | Functional outcomes | Fusion rate | Subsidence | Operative time | Blood loss | Hospital stay | Complications |
|---|---|---|---|---|---|---|---|---|---|
| Fernández-Fairen et al. (2019) (n=57) | 1-level ACDF with tantalum cages vs. autologous bone graft & plating | Tantalum: Δ at follow-up, −2.6±1.8 | NDI tantalum: Δ at follow-up, −32.2±20.1 | Tantalum: 96%; autograft: 100% | Tantalum: 44%; autograft: 33% | – | – | – | Tantalum: 7 slight deformations of tantalum implant; 3 patients with metallic particles close to the tantalum cages |
| Autograft: Δ at follow-up: −2.1±1.4 | NDI autograft: Ä at follow-up, −24.0±12.3 | ||||||||
| SF36 tantalum: Ä at follow-up, 13.7±5.0 | |||||||||
| SF36 autograft: Δ at follow-up, 11.5±5.2 | |||||||||
| Mastronardi et al. (2018) (n=88) | 1–2-level ACDF with tantalum cage | – | Nurick scale: pre-op, 1.53±0.5; follow-up, 0.61±0.3 | 97.70% | 0% | 1-level: 75 [55–80] min; 2-level: 93 [75–105] min | – | 1.43 [1–3] days | Worsening myelopathy in 4.5%, wound infection in 1.1%, transient hoarseness in 4.5%, transient swallowing difficulties in 4.5% |
| mJOA scale: pre-op, 12.5±1.5; follow-up, 14.7±1.3 | |||||||||
| Tomé-Bermejo et al. (2017) (n=33) | 1–2-level ACDF with tantalum cages | Pre-op: 8.4±2.0; follow-up: 3.6±3.3 | NDI: pre-op, 49.2±20.6; follow-up, 22.8±24.4 | 100% | >3 mm in 26.8% | – | – | Majority discharged within 4 days | 1 superficial wound infection, 1 seroma, 1 persistent dysphonia, 4 transient dysphagia |
| King et al. (2016) (n=10) | 1-level ACCF with tantalum cages | – | NDI: pre-op, 45%; follow-up, 10% | 100% | Anterior: 0.5±0.23 mm; posterior: 0.41±0.47 mm; cranial: 0.28±0.34 mm; caudal: 0.24±0.14 mm | – | – | – | None |
| Papacci et al. (2016) (n=99) | 1–2-level ACDF with tantalum cages | Pre-op: 7.77±2.51: follow-up: 1.80±1.48 | NDI: pre-op, 50.5±12.8; follow-up, 15.6±11.7 | – | 0% | 73.97±22.17 min | – | – | 1 infection |
| SF36: pre-op, 32.27±3.79; follow-up, 43.10±3.92 | |||||||||
| Kasliwal et al. (2013) (n=39) | 1-level ACDF with tantalum ring packed with autograft vs. tantalum cage vs. iliac crest autograft | Tantalum ring: pre-op, ~3.5; follow-up: ~1.7 | NDI tantalum ring: pre-op, ~52; follow-up, ~24 | Tantalum ring: ~35%; tantalum cage: ~42%; autograft: 100% | – | Tantalum ring: 2.4±0.7 h; tantalum cage: 2.3±0.6; autograft: 2.6±0.6 | Tantalum ring: 69.8±53.7 mL; tantalum cage: 87.1±79.0 mL; autograft: 79.1±49.1 mL | Tantalum ring: 1.6±1.0 days; tantalum cage: 1.5±0.5 days; autograft: 1.5±0.5 days | Tantalum: 5 radiographic fragmentation; 2 nonunion; 1 vertebral damage |
| Tantalum cage: pre-op: ~3.3; follow-up: ~1.4 | NDI tantalum cage: pre-op, ~50; follow-up, ~18 | ||||||||
| Autograft: pre-op: ~3.3; follow-up: ~2.0 | NDI autograft: pre-op, ~57; follow-up, ~32 | ||||||||
| SF36 tantalum ring: pre-op, 33.4±6.2; follow-up, 42.5±13.8 | |||||||||
| SF36 tantalum cage: pre-op, 34.5±9.3; follow-up, 45.8±13.0 | |||||||||
| SF36 autograft: pre-op, 28.0±7.1; follow-up, 32.7±7.4 | |||||||||
| Löfgren et al. (2010) (n=80) | 1-level ACDF with tantalum cages vs. iliac crest autograft | Tantalum: pre-op, 57; follow-up, 41 | NDI tantalum: pre-op, 36; follow-up, 30 | Tantalum: 69%; autograft: 92% | – | Tantalum: 100±18 min; autograft: 123±23 min | 90% overall with <50 mL | Tantalum: 3.6±1.1 days; autograft: 4.1±1.7 days | Tantalum: 1 infection; 2 transient hoarseness; 1 swallowing disturbance |
| Autograft: pre-op, 66; follow-up, 24 | NDI autograft: pre-op, 44; follow-up, 25 | Autograft: 1 graft dislocation; 2 nonunion; 1 sensory deficit; 6 infection | |||||||
| Fernández-Fairen et al. (2008) (n=61) | 1-level ACDF with tantalum cages vs. iliac crest autograft & plating | Tantalum: pre-op, 6.8 [5–8]; follow-up, 4.1 [2–7] | NDI tantalum: pre-op, 46.8% (38–56%); follow-up, 19% (10–34%) | Tantalum: 89.3%; autograft & plating: 84.8% | Tantalum: 7.1%; autograft & plating: 6% | Tantalum: 53 [40–62] min; autograft & plating: 98.5 [78–120] min | Tantalum: 97 [80–130] mL; autograft & plating: 289 [200–400] mL | Tantalum: <1 day; autograft & plating: 2.1 [1–5] days | Autograft & plating: 21.2% prolonged graft donor-site pain >4/10; 12.1% graft site pain >12 months out; 6% graft donor-site hematoma needing drainage; 6% transient dysphagia; 6% loosened screws 6 months out |
| Autograft & plating: pre-op, 6.8 [5–9]; follow-up, 4.7 [2–8] | NDI autograft & plating: pre-op, 48.9% (32–66%); follow-up, 20.9% (10–40%) | ||||||||
| Wigfield et al. (2003) (n=24) | 1-level ACDF with tantalum ring packed with autograft vs. tantalum cages vs. iliac crest autograft | – | NDI tantalum ring: improvement >15 post-op, 40% | Tantalum ring: 100%; tantalum cage: 100%; autograft: 85.7% | – | Tantalum ring: 2.1±0.7 h; tantalum cage: 1.72±0.6 h; autograft: 2.3±0.8 h | Tantalum ring: 71.5±81.6 mL; tantalum cage: 112.5±73.7 mL; autograft: 96.4±0.8 mL | Tantalum ring: 2.6±0.8 days; tantalum cage: 2.5±0.5 days; autograft: 3±0.8 days | Autograft: 1 collapsed graft |
| NDI tantalum cage: improvement >15 post-op, 60% | |||||||||
| NDI autograft: improvement >15 post-op, 14.3% | |||||||||
| SF36 tantalum ring: improvement post-op, 50% | |||||||||
| SF36 tantalum cage: improvement post-op, 100% | |||||||||
| SF36 autograft: improvement post-op, 66.7% |
ACDF, anterior cervical discectomy and fusion; ACCF, anterior cervical corpectomy and fusion; VAS, visual analog scale; NDI, neck disability index; SF36, short form 36; mJOA, modified Japanese orthopedic association.