P53. Early failures following cervical corpectomy reconstruction with titanium cages and anterior plating

2003 ◽  
Vol 3 (5) ◽  
pp. 146
Author(s):  
Michael Daubs
Keyword(s):  
Cervical Corpectomy ◽  
Early Failures ◽  
Anterior Plating ◽  
Titanium Cages

Biomechanical Consequences of Cervical Spondylectomy Versus Corpectomy

2008 ◽  
Vol 63 (suppl_4) ◽  
pp. ONS303-ONS308 ◽  
Author(s):  
Şeref Doğan ◽  
Seungwon Baek ◽  
Volker K.H. Sonntag ◽  
Neil R. Crawford
Keyword(s):  
Range Of Motion ◽  
Axial Rotation ◽  
Posterior Fixation ◽  
Spinal Stability ◽  
Angular Range ◽  
Anterior Instrumentation ◽  
Lateral Bending ◽  
Cervical Corpectomy ◽  
Flexion Extension ◽  
Anterior Plating

Abstract Objective: To evaluate the differences in spinal stability and stabilizing potential of instrumentation after cervical corpectomy and spondylectomy. Methods: Seven human cadaveric specimens were tested: 1) intact; 2) after grafted C5 corpectomy and anterior C4–C6 plate; 3) after adding posterior C4–C6 screws/rods; 4) after extending posteriorly to C3–C7; 5) after grafted C5 spondylectomy, anterior C4–C6 plate, and posterior C4–C6 screws/rods; and 6) after extending posteriorly to C3–C7. Pure moments induced flexion, extension, lateral bending, and axial rotation; angular motion was recorded optically. Results: After corpectomy, anterior plating alone reduced the angular range of motion to a mean of 30% of normal, whereas added posterior short- or long-segment hardware reduced range of motion significantly more (P < 0.003), to less than 5% of normal. Constructs with posterior rods spanning C3–C7 were stiffer than constructs with posterior rods spanning C4–C6 during flexion, extension, and lateral bending (P < 0.05), but not during axial rotation (P > 0.07). Combined anterior and C4–C6 posterior fixation exhibited greater stiffness after corpectomy than after spondylectomy during lateral bending (P = 0.019) and axial rotation (P = 0.001). Combined anterior and C3–C7 posterior fixation exhibited greater stiffness after corpectomy than after spondylectomy during extension (P = 0.030) and axial rotation (P = 0.0001). Conclusion: Circumferential fixation provides more stability than anterior instrumentation alone after cervical corpectomy. After corpectomy or spondylectomy, long circumferential instrumentation provides better stability than short circumferential fixation except during axial rotation. Circumferential fixation more effectively prevents axial rotation after corpectomy than after spondylectomy.

Complications of Multilevel Cervical Corpectomies and Reconstruction With Titanium Cages and Anterior Plating

2003 ◽  
Vol 16 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Hwan T. Hee ◽  
Mohammad E. Majd ◽  
Richard T. Holt ◽  
Thomas S. Whitecloud, ◽  
David Pienkowski
Keyword(s):  
Anterior Plating ◽  
Titanium Cages

Titanium cage reconstruction after cervical corpectomy

2003 ◽  
Vol 99 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Zeena Dorai ◽  
Howard Morgan ◽  
Caetano Coimbra
Keyword(s):  
Effective Means ◽  
Radiographic Evaluation ◽  
Titanium Cage ◽  
Cervical Corpectomy ◽  
Flexion Extension ◽  
Vertebral Bodies ◽  
Cervical Plate ◽  
Anterior Cervical Plate ◽  
Titanium Cages

Object The authors evaluated the efficacy of titanium cage— and anterior cervical plate (ACP)—augmented fusion for reconstruction following decompressive cervical corpectomy in nontraumatic disease. Methods Forty-five patients ranging from 37 to 77 years of age underwent anterior cervical corpectomy followed by titanium cage—assisted reconstruction in which the cages were filled with autologous bone obtained from the resected vertebral bodies (VBs). Plates were placed in all patients. Follow-up radiographic evaluation included computerized tomography scanning and plain flexion—extension radiography. Fusion was demonstrated in all but one patient without reconstruction-related complications. The single complication involved an endplate VB fracture with pistoning of the cage into the VB. The mean follow-up period was 12.9 months. Conclusions Autologous corpectomy bone—filled titanium cages supplemented with ACPs are an effective means of reconstruction after compressive cervical corpectomy. This technique provides a reasonable alternative to procedures involving long solid strut grafts obtained from the bone bank or from the patient.

Biomechanical comparison of anterior cervical spine instrumentation techniques with and without supplemental posterior fusion after different corpectomy and discectomy combinations

2012 ◽  
Vol 16 (6) ◽  
pp. 579-584 ◽  
Author(s):  
Matthias Setzer ◽  
Mohamed Eleraky ◽  
Wesley M. Johnson ◽  
Kamran Aghayev ◽  
Nam D. Tran ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Optical Tracking ◽  
Posterior Fixation ◽  
Titanium Cage ◽  
Cervical Corpectomy ◽  
Intact Condition ◽  
Anterior Plating ◽  
Cervical Plate ◽  
Anterior Cervical Plate

Object The objective of this study was to compare the stiffness and range of motion (ROM) of 4 cervical spine constructs and the intact condition. The 4 constructs consisted of 3-level anterior cervical discectomy with anterior plating, 1-level discectomy and 1-level corpectomy with anterior plating, 2-level corpectomy with anterior plating, and 2-level corpectomy with anterior plating and posterior fixation. Methods Eight human cadaveric fresh-frozen cervical spines from C2–T2 were used. Three-dimensional motion analysis with an optical tracking device was used to determine motion following various reconstruction methods. The specimens were tested in the following conditions: 1) intact; 2) segmental construct with discectomies at C4–5, C5–6, and C6–7, with polyetheretherketone (PEEK) interbody cage and anterior plate; 3) segmental construct with discectomy at C6–7 and corpectomy of C-5, with PEEK interbody graft at the discectomy level and a titanium cage at the corpectomy level; 4) corpectomy at C-5 and C-6, with titanium cage and an anterior cervical plate; and 5) corpectomy at C-5 and C-6, with titanium cage and an anterior cervical plate, and posterior lateral mass screw-rod system from C-4 to C-7. All specimens underwent a pure moment application of 2 Nm with regards to flexion-extension, lateral bending, and axial rotation. Results In all tested motions the statistical comparison was significant between the intact condition and the 2-level corpectomy with anterior plating and posterior fixation construct. All other statistical comparisons between the instrumented constructs were not statistically significant except between the 3-level discectomy with anterior plating and the 2-level corpectomy with anterior plating in axial rotation. There were no statistically significant differences between the 1-level discectomy and 1-level corpectomy with anterior plating and the 2-level corpectomy with anterior plating in any tested motion. There was also no statistical significance between the 3-level discectomy with anterior plating and the 2-level corpectomy with anterior plating and posterior fixation. Conclusions This study demonstrates that segmental plate fixation (3-level discectomy) affords the same stiffness and ROM as circumferential fusion in 2-level cervical spine corpectomy in the immediate postoperative setting. This obviates the need for staged circumferential procedures for multilevel cervical spondylotic myelopathy. Given that the posterior segmental instrumentation confers significant stability to a multilevel cervical corpectomy, the surgeon should strongly consider the placement of segmental posterior instrumentation to significantly improve the overall stability of the fusion construct after a 2-level cervical corpectomy.

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/.

Anterior Cervical Reconstruction Using Titanium Cages With Anterior Plating

Spine ◽  
1999 ◽  
Vol 24 (15) ◽  
pp. 1604 ◽  
Author(s):  
Mohammad E. Majd ◽  
Mukta Vadhva ◽  
Richard T. Holt
Keyword(s):  
Anterior Plating ◽  
Cervical Reconstruction ◽  
Titanium Cages

Cervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation

2002 ◽  
Vol 96 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Matthew T. Mayr ◽  
Brian R. Subach ◽  
Christopher H. Comey ◽  
Gerald E. Rodts ◽  
Regis W. Haid
Keyword(s):  
Spinal Stenosis ◽  
Content Type ◽  
Cervical Corpectomy ◽  
Allograft Reconstruction ◽  
Postoperative Hematoma ◽  
Asymptomatic Patients ◽  
Anterior Corpectomy ◽  
Cervical Spinal Stenosis ◽  
Anterior Plating ◽  
Fine Print

Object. The authors undertook a retrospective single-institution review of 261 patients who underwent anterior cervical corpectomy, reconstruction with allograft fibula, and placement of an anterior plating system for the treatment of cervical spinal stenosis to assess fusion rates and procedure-related complications. Methods. Between October 1989 and June 1995, 261 patients with cervical stenosis underwent cervical corpectomy, allograft fibular bone fusion, and placement of instrumentation for spondylosis (197 patients), postlaminectomy kyphosis (27 patients), acute fracture (25 patients), or ossification of the posterior longitudinal ligament (12 patients). All patients suffered neck pain and cervical myelopathy or radiculopathy refractory to medical management. Of the procedures, 133 involved a single vertebral level (two disc levels and one vertebral body), 96 involved two levels, 31 involved three levels, and a single patient underwent a four-level procedure. Clinical and radiographic outcomes were assessed postoperatively and at 6-month intervals. The mean follow-up period was 25.7 months (range 24–47 months). Successful fusion was documented in 226 patients (86.6%). A stable, fibrous union developed in 33 asymptomatic patients (12.6%), whereas an unstable pseudarthrosis in two patients (0.8%) required reoperation. There were no cases of infection, spinal fluid leakage, or postoperative hematoma. Complications included transient unilateral upper-extremity weakness (two patients), dysphagia (35 transient and seven permanent), and hoarseness (35 transient and two permanent). In 14 patients (5.4%) radiological studies demonstrated evidence of hardware failure. Conclusions. Cervical corpectomy with fibular allograft reconstruction and anterior plating is an effective means of achieving spinal decompression and stabilization in cases of anterior cervical disease. Symptomatic improvement was achieved in 99.2% of patients. In their series the authors found a fusion rate of 86.6% and rates of permanent hoarseness of 3.4%, dysphagia of 0.7%, and an instrumentation failure rate of 5.4%.

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