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Early Failures Following Cervical Corpectomy Reconstruction With Titanium Mesh Cages and Anterior Plating

Daubs, Michael D., MD, FACS

doi: 10.1097/01.brs.0000166526.78058.3c
Cervical Spine
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Study Design. Retrospective case series.

Objective. To evaluate the use of titanium mesh cages in the reconstruction of the cervical spine following corpectomy.

Summary of Background Data. Previous studies have shown high successful fusion rates and low failure rates with this technique. Similar reconstruction techniques using anterior strut bone grafting and anterior plating have shown higher failure rates following multilevel corpectomies.

Methods. A retrospective review was performed of 23 consecutive patients who underwent anterior cervical corpectomy reconstructed with a titanium mesh cage, local autograft, and fixed anterior plating. Medical records and radiographs were reviewed. Average follow-up was 28 months.

Results. Seven patients (30%) had reconstruction failures. There was 1 failure (6%) in the 1-level corpectomy group and 6 (75%) in the multilevel corpectomy group. All failures occurred before 12 weeks after surgery. The remaining patients had successful fusion (70%).

Conclusion. There is a high early failure rate (75%) with the use of a titanium mesh cage and fixed anterior plating for reconstruction of multilevel corpectomies. Posterior fusion and instrumentation should be considered when using this technique for multilevel reconstructions.

Twenty-three patients had a cervical corpectomy reconstructed with a titanium mesh cage and a fixed anterior plate. Early reconstruction failures occurred in 7 patients (30%). The failure rate in the multilevel corpectomy group was 75%. Caution should be used with this technique in multilevel corpectomy reconstructions.

From the Department of Surgery, University of Nevada School of Medicine, Orthopaedic Specialists, Las Vegas, NV.

Acknowledgment date: April 21, 2004. First revision date: July 13, 2004. Acceptance date: July 16, 2004.

The device(s)/drug(s) that is/are the subject of this manuscript is/are not FDA-approved for this indication and is/are not commercially available in the United States.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Michael D. Daubs, MD, FACS, Department of Surgery, University of Nevada School of Medicine, Orthopaedic Specialists, 701 South Tonopah Drive, Las Vegas, NV 89106; E-mail: Mdd63@aol.com

© 2005 Lippincott Williams & Wilkins, Inc.