Careful follow-up after “successful” surgery: postoperative spondylolisthesis after anterior cervical corpectomy and fusion with instrumentation

2008 ◽  
Vol 69 (6) ◽  
pp. 637-640
Author(s):  
Francis H. Shen ◽  
Dino Samartzis
Keyword(s):  
Cervical Corpectomy ◽  
Anterior Cervical Corpectomy

scholarly journals Clinical Use of the Nanohydroxyapatite/Polyamide Mesh Cage in Anterior Cervical Corpectomy and Fusion Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Hui Xu ◽  
Xiaofeng Ren ◽  
Dawei Wang ◽  
Yongfei Zhao ◽  
Yan Wang ◽  
...  
Keyword(s):  
Japanese Orthopaedic Association ◽  
Clinical Use ◽  
Titanium Mesh ◽  
Polyamide 66 ◽  
Titanium Mesh Cage ◽  
Cervical Corpectomy ◽  
Cage Subsidence ◽  
Mesh Cage ◽  
Anterior Cervical Corpectomy

Purpose. This study was to report the clinical use of biomimetic nanohydroxyapatite/polyamide 66 (n-HA/PA 66) mesh cages in anterior cervical corpectomy and fusion (ACCF) surgery.Method. 95 patients who underwent single level anterior cervical corpectomy and fusion for cervical spondylosis myelopathy (CSM) in our hospital were reviewed and divided into 2 groups according to using nanohydroxyapatite/polyamide mesh cage and titanium mesh cage (TMC). Demographic data of patients and surgical, clinical, and radiological data before operation and at last follow-up were collected and compared.Result. The operation time, surgical blood loss, complications, and Japanese Orthopaedic Association scores (JOA scores) of two groups were similar. At the last follow-up both the two groups obtained 100% solid bone fusion, but the TMC group had higher rate of severe cage subsidence than the n-HA/PA 66 group (27% versus 2%).Conclusion. Nanohydroxyapatite/polyamide 66 mesh cage is safe and effective in ACCF and can be a substitution to titanium mesh cage.

scholarly journals Ectopic gas in the fibular graft after anterior cervical corpectomy and fusion

2021 ◽  
Author(s):  
Satoshi Nozawa ◽  
Hiroki Kato ◽  
Masaya Kawaguchi ◽  
Asae Nozawa ◽  
Chizuo Iwai ◽  
...  
Keyword(s):  
Early Onset ◽  
Inflammatory Responses ◽  
Late Onset ◽  
Ct Images ◽  
Fibular Graft ◽  
Cervical Corpectomy ◽  
Bone Fusion ◽  
Spinous Processes ◽  
Anterior Cervical Corpectomy

Abstract Ectopic gas in the graft is occasionally encountered upon follow-up computed tomography (CT) after anterior cervical corpectomy and fusion (ACCF). However, most cases lack inflammatory responses and manifestations of infection. We reviewed 112 patients who underwent ACCF and follow-up CT, with a minimum follow-up period of 2 years. CT images were retrospectively reviewed to confirm the presence of ectopic gas in the graft and bone fusion. Bone fusion was defined as follows: mobility less than 2 mm between spinous processes on the flection-extension radiograph or a bone bridge on CT images. Of the 112 patients, 30 (27%) patients had ectopic gas in the fibular grafts. Among them, ectopic gas was initially observed 3 months after surgery (early onset) in 23 (77%) patients and 6 months after surgery (late onset) in the remaining seven (23%) patients. Upon the latest follow-up CT, ectopic gas more frequently remained in late-onset (4/7, 57%) rather than in early-onset (3/23, 13%) cases (p = 0.033). Bone fusion was not observed when CT images exhibited ectopic gas in the graft, whereas ectopic gas was not observed when CT images exhibited bone fusion. Late-onset gas tended to significantly remain. The remaining gas was strongly associated with pseudoarthrosis.

scholarly journals Ectopic gas in the fibular graft after anterior cervical corpectomy and fusion

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Satoshi Nozawa ◽  
Hiroki Kato ◽  
Masaya Kawaguchi ◽  
Asae Nozawa ◽  
Kazunari Yamada ◽  
...  
Keyword(s):  
Early Onset ◽  
Inflammatory Responses ◽  
Late Onset ◽  
Ct Images ◽  
Fibular Graft ◽  
Cervical Corpectomy ◽  
Bone Fusion ◽  
Spinous Processes ◽  
Anterior Cervical Corpectomy

Abstract Background Ectopic gas in the graft is occasionally encountered upon follow-up computed tomography (CT) after anterior cervical corpectomy and fusion (ACCF). However, most cases lack inflammatory responses and manifestations of infection. Although the clinical significance of ectopic gas in the graft has not yet been established, to the best of our knowledge, no previous studies have described ectopic gas in the graft after ACCF. This study evaluated ectopic gas in the fibular graft upon follow-up CT after ACCF. Methods We reviewed 112 patients who underwent ACCF and follow-up CT, with a minimum follow-up period of 3 years. CT images were retrospectively reviewed to confirm the presence of ectopic gas in the graft and bone fusion. Bone fusion was defined as follows: mobility less than 2 mm between spinous processes on the flection-extension radiograph or a bone bridge on CT images. Results Of the 112 patients, 30 (27%) patients had ectopic gas in the fibular grafts. Among them, ectopic gas was initially observed 3 months after surgery (early onset) in 23 (77%) patients and 6 months after surgery (late-onset) in the remaining seven (23%) patients. Upon the latest follow-up CT, ectopic gas more frequently remained in late-onset (4/7, 57%) rather than in early-onset (3/23, 13%) cases (p = 0.033). Bone fusion was not observed when CT images exhibited ectopic gas in the graft, whereas ectopic gas was not observed when CT images exhibited bone fusion. Conclusion Ectopic gas in the fibular graft was observed at both early and late-onset after ACCF; late-onset gas remained significantly. The remaining gas was strongly associated with pseudoarthrosis; therefore, pseudoarthrosis should be considered when ectopic gas in the graft is observed on CT images.

Vertebral Autograft Used as Bone Transplant for Anterior Cervical Corpectomy: Technical Note

Neurosurgery ◽  
2003 ◽  
Vol 52 (2) ◽  
pp. 449-454 ◽  
Author(s):  
Andreas Rieger ◽  
Carsten Holz ◽  
Thomas Marx ◽  
Lhagva Sanchin ◽  
Matthias Menzel
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Titanium Mesh ◽  
Titanium Mesh Cage ◽  
Bone Material ◽  
Cervical Corpectomy ◽  
Mesh Cage ◽  
Vertebral Bodies ◽  
Anterior Cervical Corpectomy

Abstract OBJECTIVE In this prospective patient study, we used a surgical technique for autograft bone fusion during anterior cervical corpectomy (ACC) in patients experiencing cervical spondylotic myelopathy. We packed the resected bone material of the corpectomy into a titanium mesh cage. To evaluate the efficacy of our autograft technique, we analyzed the results according to neurological outcome, radiological outcome, and complications. METHODS Between 1995 and 1998, 27 ACC operations were performed for cervical spondylotic myelopathy caused by multisegmental cervical spondylosis. In all patients, decompression of the cervical canal and/or spinal nerve roots was performed by a median cervical corpectomy by an anterior approach. After the ACC was completed, a titanium mesh cage, which was variable in diameter and length, was filled with morselized and impacted bone material from the cervical corpectomy and was then implanted. An anterior cervical plate was placed in all patients to achieve primary stability of the cervical vertebral column. Age, sex, pre- and postoperative myelopathy, number of decompressed levels, radiological results, and complications were assessed. The severity of myelopathy was graded according to the scoring system of the Japanese Orthopaedic Association. RESULTS Symptomatic improvement of neurological deficits was achieved in 80% of the patients. The mean preoperative Japanese Orthopaedic Association score improved from 13.1 to 15.2 postoperatively (P < 0.05). No patient demonstrated worsening of myelopathic symptoms. Radiological follow-up studies demonstrated complete bony fusion in all patients. A vertical movement of 2.25 ± 0.43 mm of the titanium cage into the adjacent vertebral bodies was observed in 24 patients. In patients with either a lordotic or neutral cervical spinal axis postoperatively, the axis remained unchanged during the entire follow-up period. CONCLUSION The results of this study demonstrate that transplantation of autograft bone material harvested during the ACC integrated well in the cage and in the adjacent vertebral bodies. Thus, complications associated with explantation of autograft material from other donor sites, e.g., the iliac crest, could be avoided. The early postoperative and midterm follow-up periods provided no evidence of morphological or functional instability of the operated cervical segments when this autograft technique was used in combination with cervical instrumentation.

scholarly journals Multilevel Anterior Cervical Corpectomy and Fusion for Ossification of the Posterior Longitudinal Ligament

2020 ◽  
Author(s):  
Zhichao Zhang ◽  
Jingxuan Chen ◽  
Wenmao Huang ◽  
Yin Zhao ◽  
Yanqing Sun ◽  
...  
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Positive Outcomes ◽  
Titanium Mesh ◽  
Improvement Rate ◽  
Cervical Corpectomy ◽  
Japanese Orthopedic Association ◽  
Anterior Cervical Corpectomy ◽  
Vertebra Body ◽  
The Ideal

Abstract Background Cervical ossification of the posterior longitudinal ligament (OPLL) is a kind of spinal disorder widely spared in Asia. In dealing with multilevel cervical OPLL, the ideal surgical approach is still under debate. Here we introduce our findings of multilevel anterior cervical corpectomy and fusion (ACCF) in treating multilevel cervical OPLLMethods 79 patients with multilevel cervical OPLL who had ACOR on C4-C5 or C5-C6 were retrospectively reviewed. Patients’ Japanese Orthopedic Association (JOA) Score, the improvement rate of JOA Scores (RIS), sagittal cervical mobility (SCM) and the distance between the lower endplate of the vertebra body above the titanium mesh and the superior endplate of the vertebra body below the titanium mesh ( L ) were analyzed and subjected into paired-t test. Radiographic features and complications were described as well.Results p<0.001 in all paired-t tests of JOA Scores, SCM and L at 1day, 6months, 1year and 2year follow-ups compared with preoperative ones. Patients’ RIS continued to increase in 2 years. 6 (7.59%) patients’ L at the 2 years follow-up shortened more than 10mm than their postoperative L. 1 (1.27%) patient had severe titanium mesh canting.Conclusions Multilevel ACCF procedure has positive outcomes in treating multilevel cervical OPLL. Postoperative complications like titanium subsidence and dislocation can happen after this procedure. Follow-ups should be conducted regularly and thoroughly with this kind of patients.

scholarly journals Factors Affecting Titanium Mesh Cage Subsidence in Single-level Anterior Cervical Corpectomy and Fusion for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Author(s):  
Yifan Tang ◽  
Fengning Li ◽  
Xiangwu Geng ◽  
Lianshun Jia ◽  
Shengyuan Zhou ◽  
...  
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Titanium Mesh ◽  
Titanium Mesh Cage ◽  
Cervical Corpectomy ◽  
Single Level ◽  
Significant Difference ◽  
Cage Subsidence ◽  
Mesh Cage ◽  
Anterior Cervical Corpectomy

Abstract Background: To analyze risk factors of titanium mesh cage (TMC) subsidence in single-level anterior cervical corpectomy and fusion (ACCF) for cervical ossification of the posterior longitudinal ligament (OPLL). Methods: Patients with cervical OPLL who were treated with single-level ACCF between January 2019 to December 2019 were retrospectively analyzed in two groups: patients with TMC subsidence as Group S, and patients with no TMC subsidence as Group N during the one-year follow-up period. The degree of distraction between decompression of the vertebral bodies and correction of the cervical curvature was measured to analyze their relationship with TMC subsidence. Results: There was no significant difference in patient demographics and complications between the two groups. The degree of distraction in Group S was significantly higher than that in Group N. The change of C2 to C7 Cobb angle (α) in Group S was significantly greater than that in Group N, and the interspinous process distance (SPD) in Group S was also significantly greater than that in Group N. The JOA score and JOA recovery rate were not statistically different between the two groups.Conclusions: Intraoperative selection of overlength TMC in single-level ACCF for OPLL, over-distraction, and excessive correction of the cervical curvature may cause TMC subsidence after surgery. No significant impact of TMC subsidence on the surgical outcome was observed during the 1-year follow-up period.

scholarly journals Anterior cervical corpectomy and fusion with stand-alone cages in patients with multilevel degenerative cervical spine disease is safe

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Mohamed H. Tohamy ◽  
Georg Osterhoff ◽  
Ahmed Shawky Abdelgawaad ◽  
Ali Ezzati ◽  
Christoph-E. Heyde
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Significant Loss ◽  
Cervical Corpectomy ◽  
Anterior Plating ◽  
Degenerative Cervical Spine ◽  
Anterior Cervical Corpectomy ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Abstract Background In case of spinal cord compression behind the vertebral body, anterior cervical corpectomy and fusion (ACCF) proves to be a more feasible approach than cervical discectomy. The next step was the placement of an expandable titanium interbody in order to restore the vertebral height. The need for additional anterior plating with ACCF has been debatable and such technique has been evaluated by very few studies. The objective of the study is to evaluate radiographic and clinical outcomes in patients with multilevel degenerative cervical spine disease treated by stand-alone cages for anterior cervical corpectomy and fusion (ACCF). Methods Thirty-one patients (66.5 ± 9.75 years, range 53–85 years) were analyzed. Visual Analog Scale (VAS) and the 10-item Neck Disability Index (NDI) were assessed preoperatively and during follow-up on a regular basis after surgery and after one year at least. Assessment of radiographic fusion, subsidence, and lordosis measurement of Global cervical lordosis (GCL); fusion site lordosis (FSL); the anterior interbody space height (ant. DSH); the posterior interbody space height (post. DSH); the distance of the cage to the posterior wall of the vertebral body (CD) were done retrospectively. Mean clinical and radiographic follow-up was 20.0 ± 4.39 months. Results VAS-neck (p = 0.001) and VAS-arm (p < 0.001) improved from preoperatively to postoperatively. The NDI improved at the final follow-up (p < 0.001). Neither significant subsidence of the cages nor significant loss of lordotic correction were seen. All patients showed a radiographic union of the surgically addressed segments at the last follow up. Conclusions Application of a stand-alone expandable cage in the cervical spine after one or two-level ACCF without additional posterior fixation or anterior plating is a safe procedure that results in fusion. Neither significant subsidence of the cages nor significant loss of lordotic correction were seen. Trial registration Retrospectively registered. According to the Decision of the ethics committee, Jena on 25th of July 2018, that this study doesn’t need any registration. https://www.laek-thueringen.de/aerzte/ethikkommission/registrierung/.

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