Cervical corpectomy reconstruction with titanium mesh cage and anterior plating

cervical spondylosis is a disorder that is characterized by cervical and shoulder pain as the main symptoms. In some cases, it presents with myelopathy, which causes important functional disability in the adult population. There have been many surgical techniques described for treatment, with anterior cervical discectomy and fusion being the gold-standard. Studies have shown that using a cervical mesh as anterior support during a corpectomy allows for a wider decompression than other techniques; this surgical treatment comes with controversy as cage subsidence remains the greatest limitation.

to evaluate the surgical results of cervical anterior decompression with titanium cage and anterior fixation plate; establish if there is a correlation of subsidence with poor functional outcomes.

retrospective, observational and descriptive study at a tertiary level institution. The study sample was completed up to n = 126, from January 2008 to August 2011. Review clinical and radiological files of 126 patients, had at least 18-month follow-up.

sixty-five male patients (52%) were included. Age was 44 years to 84 years with an average of 66.03 years. Subsidence was present in 112/126 (88.88%) of cases. In 75 (61%) cases, subsidence was present in the inferior platform and the rest in the superior one. In the group with mild subsidence (1-3 mm), the median was 1.88 mm and in the severe group (> 3 mm) was 5.87 mm. Functional improvement according to the Nurik scale was statistically significant (p = 0.001) between preoperative and final examinations. Postoperative complications occurred in 39 patients (30.9%). Loosening was the most common complication (15.8%), followed by odynophagia (4.7%).

over time, mesh subsidence caused the loss of lordosis, leading to rectification, kyphosis in some cases and losing the sagittal balance without clinical significance in its interpretation. Bone fusion was unsatisfactory and the implant makes radiological evaluation difficult, being overvalued at the time of outpatient follow-up. We emphasize that improvements must be made to the implants in order to avoid subsidence and to improve the degree of consolidation.