Corpectomy with titanium cage reconstruction in the cervical spine

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Fusion Techniques

Background:

• Multi-level anterior cervical discectomy and fusion (ACDF) has limitations, with high failure rates reported for three-level decompressions, particularly with allograft use.
• Anterior cervical corpectomy with strut grafting is an alternative, requiring fewer fusion surfaces than multi-level ACDF.
• The efficacy of titanium cages with autologous bone graft and anterior cervical plating for cervical decompression and corpectomy requires further evaluation.

Purpose of the Study:

• To evaluate the efficacy of titanium cage reconstruction with autologous bone graft and anterior cervical plating after cervical decompression and corpectomy.
• To compare the fusion rates and clinical outcomes of this technique with existing methods for multi-level cervical disease.

Main Methods:

• Retrospective evaluation of 38 consecutive patients (aged 18-73) undergoing cervical decompression and corpectomy.
• Utilized titanium cages with autologous bone graft (resected vertebral bodies) and anterior cervical plating.
• Assessed fusion via radiographs (AP, lateral, flexion-extension) and CT scans; clinical outcomes through interviews.

Main Results:

• Solid bony fusion with graft incorporation achieved in 97.5% of patients at six months and 100% at one year.
• 84% of patients reported a ≥50% improvement in quality of life and would undergo the procedure again.
• The technique demonstrated a low complication rate.

Conclusions:

• Titanium cage reconstruction with autologous bone from corpectomy and anterior cervical plating is an effective method for reconstruction after cervical decompression.
• This approach is a viable alternative to multi-level ACDF or procedures using long strut grafts.