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  • Vertebral Body Reconstruction using Expandable Titanium Cages after Anterior Decompression for Cervical Spondylotic Myelopathy: A Review

    Final Number:

    David A. Stidd MD, MS; Ahmed Awad; Ali A. Baaj MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Cervical spondylotic myelopathy is a progressive debilitating disease that favorably responds to surgical decompression. The objective of this study was to review the use of expandable titanium cages for reconstruction of spine after cervical corpectomy.

    Methods: The PubMed and Google Scholar databases were queried to identify English articles reporting the use of expandable titanium cages in cervical spine surgery. Identified articles were excluded if specific information regarding the cervical spine surgeries or outcomes were not reported. Additional relevant references from these articles were also reviewed.

    Results: A total of 8 case series published from 2002 through 2012 with a combined total of 200 patients who underwent implantation of an expandable titanium cage and a mean follow up of 20 months were identified and included for review. The combined fusion rate was 98% and the mean correction of cervical lordosis reported for 125 patients was 12.2°. The combined complication rate was 10% and the overall reported outcomes were favorable.

    Conclusions: The results of this review demonstrate that the use of expandable titanium cages is safe and effective after decompression in the treatment of cervical spondylotic myelopathy. The features of the expandable titanium cages allow for easier incorporation of the cage into a corpectomy defect relative to a static titanium mesh cage, adding structural support and restoring sagittal alignment.

    Patient Care: This review supports the use of exapandable titanium cages after cervical corpectomy as a safe and effective treatment.

    Learning Objectives: Review use of expandable cages for cervical spondylotic myelopathy.

    References: 1. Coumans JV, Marchek CP, Henderson FC: Use of the telescopic plate spacer in treatment of cervical and cervicothoracic spine tumors. Neurosurgery 51:417-424; discussion 424-416, 2002. 2. Woiciechowsky C: Distractable vertebral cages for reconstruction after cervical corpectomy. Spine (Phila Pa 1976) 30:1736-1741, 2005. 3. Auguste KI, Chin C, Acosta FL, Ames CP: Expandable cylindrical cages in the cervical spine: a review of 22 cases. J Neurosurg Spine 4:285-291, 2006. 4. Payer M: Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases. Acta Neurochir (Wien) 148:1173-1180; discussion 1180, 2006. 5. Cabraja M, Abbushi A, Koeppen D, Kroppenstedt S, Woiciechowsky C: Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome. Neurosurg Focus 28:E15, 2010. 6. Cabraja M, Abbushi A, Kroppenstedt S, Woiciechowsky C: Cages with fixation wings versus cages plus plating for cervical reconstruction after corpectomy - is there any difference? Cent Eur Neurosurg 71:59-63, 2010. 7. Burkett CJ, Baaj AA, Dakwar E, Uribe JS: Use of titanium expandable vertebral cages in cervical corpectomy. J Clin Neurosci 19:402-405, 2012. 8. Zairi F, Aboukais R, Thines L, Allaoui M, Assaker R: Relevance of expandable titanium cage for the treatment of cervical spondylotic myelopathy. Eur Spine J 21:1545-1550, 2012.

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