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Experience with a modular PEEK system for cervical vertebral body replacement.
1Neurochirurgische Klinik, Klinikum Karlsruhe, Karlsruhe, Germany.
Journal of Spinal Disorders & Techniques
|August 8, 2014
Summary
This study found the ATHLET vertebral body replacement (VBR) system easy to implant for cervical spondylotic myelopathy. However, due to high rates of implant subsidence and dislocation, it is not recommended.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedic Devices
Background:
- Cervical spondylotic myelopathy (CSM) is a degenerative condition affecting the spinal cord in the neck.
- Surgical intervention is often required to decompress the spinal cord and stabilize the cervical spine.
- Vertebral body replacement (VBR) is a surgical technique used in CSM treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of the ATHLET VBR system combined with the TOSCA plating system for treating cervical spondylotic myelopathy.
- To assess implant positioning, cervical lordosis, and patient outcomes.
Main Methods:
- A retrospective case series of 20 patients undergoing corpectomy and ATHLET VBR.
- Preoperative and postoperative assessments included Japanese Orthopedic Association (JOA) scores, Odom criteria, and radiographic studies.
- Mean follow-up was 20 months.
Main Results:
- ATHLET VBR implantation was uncomplicated; height adjustment allowed for lordosis restoration.
- Complications included 10% implant dislocation (in two-level corpectomies) and 20% secondary subsidence.
- Patient outcomes: 50% excellent, 30% good, 10% satisfactory, 20% poor (Odom criteria); average JOA score improvement was 1.6.
Conclusions:
- The ATHLET VBR system is technically easy to implant and eliminates bone graft morbidity.
- High rates of secondary subsidence (20%) and dislocation (10%), along with a significant percentage of unsatisfactory outcomes (20%), lead to a recommendation against its use for cervical VBR.
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