Single stage anterior reconstruction using titanium mesh cages in neglected kyphotic tuberculous spondylodiscitis of the cervical spine

Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data.Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clinical and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25) spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0.Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of vertebrogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle (NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA (p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) according to the Charlson scale.Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compensation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance parameters, with the possibility of long-term maintaining the achieved values.

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Cervical spine metastases: techniques for anterior reconstruction and stabilization

Neurosurgical Review ◽

10.1007/s10143-012-0388-z ◽

2012 ◽

Vol 35 (4) ◽

pp. 463-475 ◽

Cited By ~ 6

Author(s):

Christina M. Sayama ◽

Meic H. Schmidt ◽

Erica F. Bisson

Keyword(s):

Cervical Spine ◽

Spine Metastases ◽

Anterior Reconstruction

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Cervical spinal metastasis: anterior reconstruction and stabilization techniques after tumor resection

Neurosurgical FOCUS ◽

10.3171/foc.2003.15.5.2 ◽

2003 ◽

Vol 15 (5) ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

James K. Liu ◽

Ronald I. Apfelbaum ◽

Bennie W. Chiles ◽

Meic H. Schmidt

Keyword(s):

Cervical Spine ◽

Spinal Metastasis ◽

Posterior Instrumentation ◽

Tumor Resection ◽

Spinal Metastases ◽

Metastatic Tumor ◽

Subaxial Cervical Spine ◽

Bone Autograft ◽

Anterior Reconstruction ◽

Anterior Cervical Corpectomy

Object In a review of the literature, the authors provide an overview of various techniques that have evolved for reconstruction and stabilization after resection for metastatic disease in the subaxial cervical spine. Methods Reconstruction and stabilization of the cervical spine after vertebral body (VB) resection for metastatic tumor is an important goal in the surgical management of spinal metastasis. Generally, the VB defect is reconstructed with bone autograft or allograft, polymethylmethacrylate (PMMA), interbody spacers, and/or cages. In cases of PMMA-assisted reconstruction, internal devices are used to augment the fixation of PMMA. Stabilization is then achieved with anterior instrumentation, usually an anterior cervical locking plate. In some cases, posterior instrumentation may be necessary to supplement the anterior construct. Conclusions Anterior cervical corpectomy followed by reconstruction and stabilization is an effective strategy in the management of spinal metastases in patients.

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