Expandable titanium cages for anterior column cervical reconstruction and their effect on sagittal profile: a review of 48 cases
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Expandable cervical cages have been utilised successfully to reconstruct the cervical spine for various conditions. However, to date there are only limited data on their influence on cervical sagittal profile. In this retrospective study, we present our experience with performing anterior cervical corpectomy in one or two levels using expandable titanium cages in order to achieve stable reconstruction and restoration of cervical lordosis.
A case series of data from 48 consecutive patients (20 men, 28 women; mean age 61 years) operated upon in a 5-year-period is retrospectively reviewed. Standard anterior single- or two-level cervical corpectomy, fusion and spinal reconstruction were performed, including placement of an expandable titanium cage and an anterior cervical plate. The mean follow-up was 23 months (range, 8–42 months). Outcome was measured by clinical examinations and visual analogue scale (VAS) scale; myelopathy was classified according the Nurick grading system. Radiographic analysis comprised several parameters, including segmental Cobb angle, cervical lordosis, subsidence ratio and sagittal cage angle. Computed tomography was done 1 and 2 years after surgery; cervical spine radiographs were obtained 3, 6, 12 and 24 months after surgery.
In 38 patients (79 %) osseous fusion or stability of construct could be demonstrated in the 2-year follow up examination. The mean restoration of segmental Cobb angle as well as cervical lordosis amounted to 7.6° and 5.4° respectively, both being statistically significant. Furthermore, a profound correction (10° or more) of the sagittal cervical curve was shown in 15 patients.
Regarding the restoration of the physiological sagittal cervical profile, expandable cervical cages seem to be efficient and easy to use for cervical spine reconstruction after anterior corpectomy. Donor-site-related complications are avoided, fast and strong reconstruction of the anterior column is provided, resulting in satisfactory fusion rates after 2 years.
KeywordsCervical spine Corpectomy Expandable cervical cage Sagittal profile
Conflicts of interest
- 7.Buttermann GR, Glazer PA, Bradford DS (1996) The use of bone allografts in the spine. Clin Orthop Relat Res :75–85Google Scholar
- 17.Nassr A, Khan MH, Ali MH, Espiritu MT, Hanks SE, Lee JY, Donaldson WF, Kang JD (2009) Donor-site complications of autogenous nonvascularized fibula strut graft harvest for anterior cervical corpectomy and fusion surgery: experience with 163 consecutive cases. Spine J 9:893–898PubMedCrossRefGoogle Scholar
- 26.Wang JC, Hart RA, Emery SE, Bohlman HH (2003) Graft migration or displacement after multilevel cervical corpectomy and strut grafting. Spine (Phila Pa 1976) 28:1016–1021, discussion 1021–1012Google Scholar