Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis

Background. Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. The selection of a proper rod material is crucial due to their specific mechanical properties that influence the surgical outcome. The purpos...

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Main Authors: Frank D. Shega, HongQi Zhang, Daudi R. Manini, MingXing Tang, ShaoHua Liu
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2020/8475910
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author Frank D. Shega
HongQi Zhang
Daudi R. Manini
MingXing Tang
ShaoHua Liu
author_facet Frank D. Shega
HongQi Zhang
Daudi R. Manini
MingXing Tang
ShaoHua Liu
author_sort Frank D. Shega
collection DOAJ
description Background. Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. The selection of a proper rod material is crucial due to their specific mechanical properties that influence the surgical outcome. The purpose of this study is to compare the effectiveness of cobalt chromium rods versus titanium rods for the treatment of spinal deformity by a systematic review and meta-analysis. Methods. PubMed, EMBASE, and the Cochrane library were searched for observational and biomechanical studies comparing cobalt chromium and titanium rods in terms of correction rate, thoracic kyphosis, lumbar lordosis, incidence of rod fracture, fatigue life of contoured rod, bending stiffness of rods, and occurrence of proximal junctional kyphosis. The demographic data and mean values of outcomes of interest were extracted from each group and compared by their mean difference as an overall outcome measure. The Review Manager software (RevMan 5.3) was utilized at a 95% significance level. Results. Eleven eligible studies with 641 participants for 7 observational studies and 35 samples for 4 biomechanical studies were identified. There were no significant differences between cobalt chromium and titanium rods in the correction rate of spinal deformity. Postoperative thoracic kyphosis was well restored in the cobalt chromium group with statistical significance (p value = 0.009). The incidence of rod fracture was high in titanium rods compared to cobalt chromium rods with significant difference (p value = 0.0001). Proximal junctional kyphosis occurs more in the cobalt chromium group with a significant difference (p value = 0.0009). No statistical significance between two materials in terms of lumbar lordosis, fatigue of life, and bending stiffness of rods. Conclusion. The cobalt chromium rod is better than titanium rod for effective correction of spinal deformity and postoperative stability of the spine. However, the use of cobalt chromium rods is associated with increased risk of proximal junctional kyphosis.
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spelling doaj-art-d00cb259dec44f1c9867def66f138ae22025-02-03T01:28:21ZengWileyAdvances in Orthopedics2090-34642090-34722020-01-01202010.1155/2020/84759108475910Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-AnalysisFrank D. Shega0HongQi Zhang1Daudi R. Manini2MingXing Tang3ShaoHua Liu4Department of Spine Surgery, Xiangya Hospital of Central South University, Changsha City 410008, Hunan Province, ChinaDepartment of Spine Surgery, Xiangya Hospital of Central South University, Changsha City 410008, Hunan Province, ChinaDepartment of Spine Surgery, Xiangya Hospital of Central South University, Changsha City 410008, Hunan Province, ChinaDepartment of Spine Surgery, Xiangya Hospital of Central South University, Changsha City 410008, Hunan Province, ChinaDepartment of Spine Surgery, Xiangya Hospital of Central South University, Changsha City 410008, Hunan Province, ChinaBackground. Biomechanical properties of rods determine their ability to correct spinal deformity and prevention of postoperative sagittal and coronal changes. The selection of a proper rod material is crucial due to their specific mechanical properties that influence the surgical outcome. The purpose of this study is to compare the effectiveness of cobalt chromium rods versus titanium rods for the treatment of spinal deformity by a systematic review and meta-analysis. Methods. PubMed, EMBASE, and the Cochrane library were searched for observational and biomechanical studies comparing cobalt chromium and titanium rods in terms of correction rate, thoracic kyphosis, lumbar lordosis, incidence of rod fracture, fatigue life of contoured rod, bending stiffness of rods, and occurrence of proximal junctional kyphosis. The demographic data and mean values of outcomes of interest were extracted from each group and compared by their mean difference as an overall outcome measure. The Review Manager software (RevMan 5.3) was utilized at a 95% significance level. Results. Eleven eligible studies with 641 participants for 7 observational studies and 35 samples for 4 biomechanical studies were identified. There were no significant differences between cobalt chromium and titanium rods in the correction rate of spinal deformity. Postoperative thoracic kyphosis was well restored in the cobalt chromium group with statistical significance (p value = 0.009). The incidence of rod fracture was high in titanium rods compared to cobalt chromium rods with significant difference (p value = 0.0001). Proximal junctional kyphosis occurs more in the cobalt chromium group with a significant difference (p value = 0.0009). No statistical significance between two materials in terms of lumbar lordosis, fatigue of life, and bending stiffness of rods. Conclusion. The cobalt chromium rod is better than titanium rod for effective correction of spinal deformity and postoperative stability of the spine. However, the use of cobalt chromium rods is associated with increased risk of proximal junctional kyphosis.http://dx.doi.org/10.1155/2020/8475910
spellingShingle Frank D. Shega
HongQi Zhang
Daudi R. Manini
MingXing Tang
ShaoHua Liu
Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis
Advances in Orthopedics
title Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis
title_full Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis
title_fullStr Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis
title_full_unstemmed Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis
title_short Comparison of Effectiveness between Cobalt Chromium Rods versus Titanium Rods for Treatment of Patients with Spinal Deformity: A Systematic Review and Meta-Analysis
title_sort comparison of effectiveness between cobalt chromium rods versus titanium rods for treatment of patients with spinal deformity a systematic review and meta analysis
url http://dx.doi.org/10.1155/2020/8475910
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