Multilevel vertebral body replacement with a titanium mesh spacer for aneurysmal bone cyst: technical note

A 64-year-old male presented with abrupt tetraparesis caused by a minor impact. Diagnostic images obtained on admission showed an aneurysmal bone cyst visible in the cervical spine at the fourth to upper sixth level, although the patient had been wearing a halo brace to diminish the symptoms. The vertebral body from the fourth to the sixth level was dissected, and this space was packed with a titanium cage filled with ceramic bone fragments mixed with fibrin glue. The combination of a titanium cage and an anterior locking plate can be made easily for anterior spinal fusion with enough rigidity to maintain the necessary space during fusion without any major support equipment. Both edges of the titanium mesh cage cut into the vertebral body to hold the cage in place. The other part, the titanium plate, makes it secure until ceramic bone fragments in the cage promote bony ingrowth for fusion.