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Relevance of expandable titanium cage for the treatment of cervical spondylotic myelopathy

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Abstract

Background

In patients with cervical spondylotic myelopathy, ventral disease and loss of physiological cervical lordosis are indications for anterior approach. As bone graft and titanium cage present many drawbacks, expandable titanium cage has been recently introduced for this indication. The authors present the clinical and radiological outcomes in patients undergoing the placement of an expandable cage in the treatment of spondylotic myelopathy with straight or kyphotic cervical spine alignment.

Methods

This was a retrospective review of prospectively collected data. A total of 26 patients underwent cervical corpectomy and reconstruction using an expandable titanium cage and anterior plate between 2005 and 2008. Pain and functional disability were measured using VAS and mJOA preoperatively and at 3 months, 6 months, 1 year and 2 years. Kyphosis was measured using lateral radiographs at the same points of follow-up. Fusion was evaluated on flexion–extension radiographs at 2 years.

Results

The mean VAS improved from 4.2 to 1.7 and the mean mJOA increased from 12.85 to 16.04 at 2 years postoperatively (p < 0.05). The mean kyphosis angle decreased from 17° to 2° at the last follow-up (p < 0.05). The fusion rate was 100 % at 2 years. Three complications were reported including a transient dysphagia, an epidural hematoma and an early hardware migration.

Conclusion

Expandable titanium cage is an effective device, which achieves good clinical and radiological outcomes at a minimum 2-year follow-up.

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References

  1. Kadanka Z, Mares M, Bednarika J, Smrca V, Krbec M, Chaloupka R, Dusek L (2005) Predictive factors for mild forms of spondylotic cervical myelopathy treated conservatively or surgically. Eur J Neurol 12:16–24

    Article  PubMed  CAS  Google Scholar 

  2. Wada E, Suzuki S, Kanazawa A, Matsuoka T, Miyamoto S, Yonenobu K (2001) Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years. Spine 26:1443–1447

    Article  PubMed  CAS  Google Scholar 

  3. Wittenberg RH, Moeller J, Shea M, White AA, Hayes WC (1990) Compressive strength of autologous and allogenous bone grafts for thoracolumbar and cervical spine fusion. Spine 15:1073–1078

    Article  PubMed  CAS  Google Scholar 

  4. Kinoshita A, Kataoka K, Taneda M (1999) Multilevel vertebral body replacement with a titanium mesh spacer for aneurysmal bone cyst: technical note. Minim Invasive Neurosurg 42:156–158

    Article  PubMed  CAS  Google Scholar 

  5. Dorai Z, Morgan H, Coimbra C (2003) Titanium cage reconstruction after cervical corpectomy. J Neurosurg 99:3–7

    PubMed  Google Scholar 

  6. Auguste KI, Chin C, Acosta FL, Ames CP (2006) Expandable cylindrical cages in the cervical spine: a review of 22 cases. J Neurosurg Spine 4:285–291

    Article  PubMed  Google Scholar 

  7. Benzel EC, Lancon J, Kesterson L, Hadden T (1991) Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy. J Spinal Disord 4:286–295

    Article  PubMed  CAS  Google Scholar 

  8. Woiciechowsky C (2005) Distractable vertebral cages for reconstruction after cervical corpectomy. Spine 30:1736–1741

    Article  PubMed  Google Scholar 

  9. Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:602–617

    Article  PubMed  CAS  Google Scholar 

  10. Kandziora F, Pflugmacher R, Schaefer J, Scholz M, Ludwig K, Schleicher P, Haas NP (2003) Biomechanical comparison of expandable cages for vertebral body replacement in the cervical spine. J Neurosurg 99:91–97

    Article  PubMed  Google Scholar 

  11. Kristof RA, Kiefer T, Thudium M, Ringel F, Stoffel M, Kovacs A, Mueller CA (2009) Comparison of ventral corpectomy and plate–screw-instrumented fusion with dorsal laminectomy and rod–screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy. Eur Spine J 18(12):1951–1956

    Article  PubMed  Google Scholar 

  12. Dickerman RD, Reynolds AS, Bennett M (2010) Cervical spondylotic myelopathy: a complex problem where approach is patient dependent. Eur Spine J 19(1):150–151

    Article  PubMed  Google Scholar 

  13. Ghogawala Z, Martin B, Benzel EC, Dziura J, Magge SN, Abbed KM et al (2011) Comparative effectiveness of ventral vs dorsal surgery for cervical spondylotic myelopathy. Neurosurgery 68(3):622–630

    Article  PubMed  Google Scholar 

  14. Bapat MR, Chaudhary K, Sharma A, Laheri V (2008) Surgical approach to cervical spondylotic myelopathy on the basis of radiological patterns of compression: prospective analysis of 129 cases. Eur Spine J 17(12):1651–1663

    Article  PubMed  Google Scholar 

  15. Matz PG, Pritchard PR, Hadley MN (2007) Anterior cervical approach for the treatment of cervical myelopathy. Neurosurgery 60:S64–S70

    Article  PubMed  Google Scholar 

  16. Wang JC, McDonough PW, Endow KK, Delamarter RB (2001) A comparison of fusion rates between single-level cervical corpectomy and two-level discectomy and fusion. J Spinal Disord 14:222–225

    Article  PubMed  CAS  Google Scholar 

  17. Lin Q, Zhou X, Wang X, Cao P, Tsai N, Yuan W (2012) A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy. Eur Spine J 21(3):474–481

    Article  PubMed  Google Scholar 

  18. Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine 27:2453–2458

    Article  PubMed  Google Scholar 

  19. Thongtrangan I, Balabhadra RS, Le H, Park J, Kim DH (2003) Vertebral body replacement with an expandable cage for reconstruction after spinal tumor resection. Neurosurg Focus 15:E8

    PubMed  Google Scholar 

  20. Liljenqvist U, Lerner T, Bullmann V, Hackenberg L, Halm H, Winkelmann W (2003) Titanium cages in the surgical treatment of severe vertebral osteomyelitis. Eur Spine J 12:606–612

    Article  PubMed  CAS  Google Scholar 

  21. Sasso RC, Ruggiero RA Jr, Reilly TM, Hall PV (2003) Early reconstruction failures after multilevel cervical corpectomy. Spine 28:140–142

    Article  PubMed  Google Scholar 

  22. Vaccaro AR, Falatyn SP, Scuderi GJ, Eismont FJ, McGuire RA, Singh K, Garfin SR (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11:410–415

    PubMed  CAS  Google Scholar 

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Correspondence to Fahed Zaïri.

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Zaïri, F., Aboukais, R., Thines, L. et al. Relevance of expandable titanium cage for the treatment of cervical spondylotic myelopathy. Eur Spine J 21, 1545–1550 (2012). https://doi.org/10.1007/s00586-012-2380-2

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  • DOI: https://doi.org/10.1007/s00586-012-2380-2

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