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- Title
Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases.
- Authors
Payer, M.
- Abstract
Background. This prospective observational study was undertaken to investigate the advantages, the safety, and the drawbacks of reconstructing a cervical corpectomy with a distractible corpectomy cage. According to the author’s literature search, this is the second clinical report on a distractible cervical corpectomy cage. Method. 20 consecutive patients underwent a single- or multi-level cervical corpectomy for spondylotic myelopathy, traumatic fracture, or tumor. The corpectomy defect was reconstructed by means of a distractible titanium cage, and local bone from the corpectomy was layed around the cage for fusion. An anterior cervical plate and/or a posterior lateral mass or pedicle screw fixation was added in all patients. The average follow-up was 14 months, and all patients had at least 12 months of follow-up. Findings. No hardware failure occurred in any of the patients. Construct stability was achieved in 19 out of 20 patients (95%) at 12 months postoperatively. The mean regional lordosis was 1° preoperatively, 9° postoperatively, and 7° at the follow-up. Mean neck pain on a VAS was 3.9 preoperatively, and 2.6 at 12 months. There were three perioperative complications: transient neurological worsening in one patient, one transient vocal cord paralysis, and persistent dysphagia in one patient. Conclusion. A single- or multi-level cervical corpectomy can be safely and effectively reconstructed by a distractible titanium cage and local bone graft in combination with anterior cervical plating and/or posterior lateral mass/pedicle screw fixation. Potential advantages of this technique are an unforced cage insertion in its non-distracted position, press-fitting the cage into the corpectomy defect through cage distraction, correction of kyphosis or preservation of local lordosis through cage distraction, and the absence of donor site morbidity. However, the stability rate in the current series did not exceed the fusion rates of auto- or allografts.
- Subjects
CERVICAL vertebrae; HOMOGRAFTS; KYPHOSIS; DEGLUTITION disorders; VOCAL cords; NECK pain
- Publication
Acta Neurochirurgica, 2006, Vol 148, Issue 11, p1173
- ISSN
0001-6268
- Publication type
Article
- DOI
10.1007/s00701-006-0871-9