PDF herunterladen
CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(01): 091-100
DOI: 10.1055/s-0043-1761238
Original Article

Evaluation of Radiological and Neurological Outcomes after Anterior Cervical Corpectomy with Fusion using Expandable Cage Alone and Expandable Cage with Anterior Cervical Plating

Manoj Kumar Seervi
1   Department of Neurosurgery, Sawai Man Singh (SMS) Medical College, Jaipur, Rajasthan, India
,
Surendra Jain
1   Department of Neurosurgery, Sawai Man Singh (SMS) Medical College, Jaipur, Rajasthan, India
,
Devendra Kumar Purohit 
1   Department of Neurosurgery, Sawai Man Singh (SMS) Medical College, Jaipur, Rajasthan, India
,
Ugan Singh Meena
1   Department of Neurosurgery, Sawai Man Singh (SMS) Medical College, Jaipur, Rajasthan, India
› Institutsangaben
› Weitere Informationen
   Lizenzen und Reprints

Abstract

Objective After anterior cervical corpectomy expandable cage were used with or without using anterior cervical plate for structural support are being preferred over autologous bone graft and other types of cages. Nowadays, the preferable type of cages and application of anterior cervical plate remain a debatable topic with studies giving divergent results. The purpose of this study is to evaluate the outcomes of expandable cages used alone or expandable cage used with anterior cervical plate following anterior cervical corpectomy.

Materials and Methods This study was conducted on 100 patients from January 2019 to December 2021 and all patients were undergone anterior cervical corpectomy and fusion and divided in two groups with expandable cage only (Group A) and expandable cage with anterior cervical plate (Group B). Various long-term benefits and radiological outcomes were studied in both groups.

Statistical Analysis and Results In this study, 100 patients were included and all patients underwent corpectomy followed by insertion of expandable cage alone or with anterior cervical plate. There was an improvement in C2–C7 Cobb's angle in group B was significantly higher than group A (p < 0.05) and decrease in Nurick's scale score in group B was significantly higher than group A (p < 0.05). The outcomes were measured with fusion rate (94%), subsidence rate (15%) and change in C2–C7 Cobb's angle was 4 degrees in this study.

Conclusion Expandable cage with or without anterior cervical plate was used after anterior cervical corpectomy for various cervical pathological conditions. In this study, we conclude the long-term benefits and radiological outcomes of two groups as expandable cage was used alone or with additional application of anterior cervical plate. In this study, the results were more in favor of additional application of anterior cervical plate as compared with expandable cage alone and more studies were required in future for more established long-term benefits and drawbacks.

Keywords

cervical corpectomy - expandable cage - anterior cervical plate - radiological outcomes


Publikationsverlauf

Artikel online veröffentlicht:
27. März 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Hur JW, Ryu KS, Ahn S, Kim JS, Chung HJ, Song MS. Comparative analysis of 2 different types of titanium mesh cage for single-level anterior cervical corpectomy and fusion in terms of postoperative subsidence and sagittal alignment. Clin Spine Surg 2020; 33 (01) E8-E13
    CrossrefPubMedGoogle Scholar
  • 2 Fang T, Zhang M, Yan J. et al. Comparative analysis of 3D-printed artificial vertebral body versus titanium mesh cage in repairing bone defects following single-level anterior cervical corpectomy and fusion. Med Sci Monit 2021; 27: e928022 –e1
    CrossrefPubMedGoogle Scholar
  • 3 Doria C, Mosele GR, Balsano M, Maestretti G, Caggiari G. Anterior decompression and plate fixation in treatment of cervical myelopathy: a multicentric retrospective review. Acta Orthop Traumatol Turc 2018; 52 (03) 185-190
    CrossrefPubMedGoogle Scholar
  • 4 Dru AB, Lockney DT, Vaziri S. et al. Cervical spine deformity correction techniques. Neurospine 2019; 16 (03) 470-482
    CrossrefPubMedGoogle Scholar
  • 5 Waschke A, Kaczor S, Walter J, Duenisch P, Kalff R, Ewald C. Expandable titanium cages for anterior column cervical reconstruction and their effect on sagittal profile: a review of 48 cases. Acta Neurochir (Wien) 2013; 155 (05) 801-807 , discussion 807
    CrossrefPubMedGoogle Scholar
  • 6 Vanni D, Pantalone A, Magliani V, Salini V, Berjano P. Corpectomy and expandable cage replacement versus third generation percutaneous augmentation system in case of vertebra plana: rationale and recommendations. J Spine Surg 2017; 3 (03) 379-386 DOI: 10.21037/jss.2017.08.06.
    CrossrefPubMedGoogle Scholar
  • 7 Graillon T, Farah K, Rakotozanany P. et al. Anterior approach with expandable cage implantation in management of unstable thoracolumbar fractures: results of a series of 93 patients. Neurochirurgie 2016; 62 (02) 78-85 DOI: 10.1016/j.neuchi.2016.01.001.
    CrossrefPubMedGoogle Scholar
  • 8 Calvert G, May LA, Theiss S. Use of permanently placed metal expandable cages for vertebral body reconstruction in the surgical treatment of spondylodiscitis. Orthopedics 2014; 37 (06) e536-e542 DOI: 10.3928/01477447-20140528-53.
    CrossrefPubMedGoogle Scholar
  • 9 Alfieri A, Gazzeri R, Neroni M, Fiore C, Galarza M, Esposito S. Anterior expandable cylindrical cage reconstruction after cervical spinal metastasis resection. Clin Neurol Neurosurg 2011; 113 (10) 914-917 DOI: 10.1016/j.clineuro.2011.02.023.
    CrossrefPubMedGoogle Scholar
  • 10 Burkett CJ, Baaj AA, Dakwar E, Uribe JS. Use of titanium expandable vertebral cages in cervical corpectomy. J Clin Neurosci 2012; 19 (03) 402-405
    CrossrefPubMedGoogle Scholar
  • 11 Woiciechowsky C. Distractable vertebral cages for reconstruction after cervical corpectomy. Spine 2005; 30 (15) 1736-1741
    CrossrefPubMedGoogle Scholar
  • 12 Alexander R, Vaccaro TJA. Spine Surgery Tricks of the Trade. New York: Thieme; 2002
    Google Scholar
  • 13 Pojskic M, Saβ B, Nimsky C, Carl B. Application of an expandable cage for reconstruction of the cervical spine in a consecutive series of eighty-six patients. Medicina (Kaunas) 2020; 56 (12) 642 DOI: 10.3390/medicina56120642.
    CrossrefPubMedGoogle Scholar
  • 14 Brenke C, Fischer S, Carolus A, Schmieder K, Ening G. Complications associated with cervical vertebral body replacement with expandable titanium cages. J Clin Neurosci 2016; 32: 35-40 DOI: 10.1016/j.jocn.2015.12.036.
    CrossrefPubMedGoogle Scholar
  • 15 Arts MP, Peul WC. Vertebral body replacement systems with expandable cages in the treatment of various spinal pathologies: a prospectively followed case series of 60 patients. Neurosurgery 2008; 63 (03) 537-544 , discussion 544–545 DOI: 10.1227/01.NEU.0000325260.00628.DC.
    CrossrefPubMedGoogle Scholar
  • 16 Allouch H, Kónya S, Shousha M, Boehm H. Criteria for radiological evaluation of incorporation of stand-alone expandable cervical vertebral body replacement devices. A technical note and preliminary report. Int J Spine Res 2020; 2 (01) 46-50
    Google Scholar
  • 17 Cappelletto B, Giorgiutti F, Balsano M. Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine. J Orthop Surg (Hong Kong) 2020; 28 (01) 2309499019900472 DOI: 10.1177/2309499019900472.
    CrossrefPubMedGoogle Scholar
  • 18 Byvaltsev VA, Kalinin AA, Aliyev MA, Azhibekov NO, Shepelev VV, Riew KD. Poor fusion rates following cervical corpectomy reconstructed with an expandable cage: minimum 2-year radiographic and clinical outcomes. Neurosurgery 2021; 89 (04) 617-625 DOI: 10.1093/neuros/nyab240.
    CrossrefPubMedGoogle Scholar
  • 19 Tohamy MH, Osterhoff G, Abdelgawaad AS, Ezzati A, Heyde CE. Anterior cervical corpectomy and fusion with stand-alone cages in patients with multilevel degenerative cervical spine disease is safe. BMC Musculoskelet Disord 2022; 23 (01) 20 DOI: 10.1186/s12891-021-04883-5.
    CrossrefPubMedGoogle Scholar
  • 20 Lau D, Song Y, Guan Z, La Marca F, Park P. Radiological outcomes of static vs expandable titanium cages after corpectomy: a retrospective cohort analysis of subsidence. Neurosurgery 2013; 72 (04) 529-539 , discussion 528–529
    CrossrefPubMedGoogle Scholar
  • 21 Castro MD, Frank P, Majd MD. et al. Anterior Cervical Corpectomy and Fusion with the C–VBR. BackBone; 2018. ;1
    Google Scholar
  • 22 Liu FY. Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China, prevalence of hematoma after anterior cervical spine surgery: a meta-analysis. Int J Clin Exp Med 2017; 10 (12) 15937-15949
    Google Scholar
  • 23 Utter A, Benzel EC. . Anterior Cervical Corpectomy and Fusion: To Plate or Not to Plate. In: Clinical Gate; 2015 [cited 2022 Feb 16]. Available at: https://clinicalgate.com/anterior-cervical-corpectomy-and-fusion-to-plate-or-not-to-plate/
  • 24 Chiriac A, Faiyad Z, Popescu C. et al. Our first experience with cervical expandable cage for vertebral body reconstruction. Romanian Neurosurgery 2016;41–46.
    Google Scholar
  • 25 König SA, Spetzger U. Distractable titanium cages versus PEEK cages versus iliac crest bone grafts for the replacement of cervical vertebrae. Minim Invasive Ther Allied Technol 2014; 23 (02) 102-105
    CrossrefPubMedGoogle Scholar
  • 26 Spivak JM, Bharam S, Chen D, Kummer FJ. Internal fixation of cervical trauma following corpectomy and reconstruction. The effects of posterior element injury. Bull Hosp Jt Dis 2000; 59 (01) 47-51
    PubMedGoogle Scholar
  • 27 Grubb MR, Currier BL, Shih JS, Bonin V, Grabowski JJ, Chao EY. Biomechanical evaluation of anterior cervical spine stabilization. Spine 1998; 23 (08) 886-892
    CrossrefPubMedGoogle Scholar
  • 28 Kandziora F, Pflugmacher R, Schaefer J. et al. Biomechanical comparison of expandable cages for vertebral body replacement in the cervical spine. J Neurosurg 2003; 99 (1, Suppl) 91-97 DOI: 10.3171/spi.2003.99.1.0091.
    CrossrefPubMedGoogle Scholar
  • 29 Panjabi MM, White III AA, Johnson RM. Cervical spine mechanics as a function of transection of components. J Biomech 1975; 8 (05) 327-336
    CrossrefPubMedGoogle Scholar