Sebastian Hartmann1, Anja Tschugg2, Jochen Obernauer2, Sabrina Neururer3, Ondra Petr2, Claudius Thomé2. 1. Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. sebastian.hartmann@i-med.ac.at. 2. Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. 3. Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria.
Abstract
OBJECTIVES: Cervical corpectomy is an uncommon procedure and there are only limited data on the procedure's indications, surgical approaches, and complications. The diagnosis, indications, surgical planning, and complications of cervical corpectomy were therefore surveyed to clarify the treatment strategies used by spinal surgeons in central Europe, with special attention to preoperative planning and decision-making for additional dorsal approaches in multilevel cases. MATERIALS AND METHODS: An online survey with 18 questions on the preoperative, intraoperative, and postoperative management of cervical corpectomies was conducted. The relevant specialist societies in Germany and Austria provided 1137 contacts for surgeons, and the responses were compared with recent literature reports. RESULTS: In all, 302 surgeons (27 %) completed the survey, with wide variability in the treatment options offered. Most (51 %) perform fewer than five anterior cervical corpectomy and fusion (ACCF) procedures per year; 35 % do 5-20 per year. Anterior cervical discectomy and fusion (ACDF) was preferred by 41 % of the participants to laminoplasty/laminectomy (19 %/16 %) and ACCF (12 %). Most indications for ACCF involved degenerative (27 %), traumatic (17 %), and neoplastic (20 %) conditions. Intraoperative and postoperative complications were mainly associated with hardware failure. One-third of the surgeons tend to use an additional dorsal approach to increase the corpectomy construct's stability for either two-level or three-level corpectomies. CONCLUSIONS: There is no current consensus in central Europe on the treatment of complex cervical disease and cervical corpectomy. The procedure is still rare, and the need for additional dorsal fixation is unclear. Further studies are needed in order to establish evidence-based standards for patient care.
OBJECTIVES: Cervical corpectomy is an uncommon procedure and there are only limited data on the procedure's indications, surgical approaches, and complications. The diagnosis, indications, surgical planning, and complications of cervical corpectomy were therefore surveyed to clarify the treatment strategies used by spinal surgeons in central Europe, with special attention to preoperative planning and decision-making for additional dorsal approaches in multilevel cases. MATERIALS AND METHODS: An online survey with 18 questions on the preoperative, intraoperative, and postoperative management of cervical corpectomies was conducted. The relevant specialist societies in Germany and Austria provided 1137 contacts for surgeons, and the responses were compared with recent literature reports. RESULTS: In all, 302 surgeons (27 %) completed the survey, with wide variability in the treatment options offered. Most (51 %) perform fewer than five anterior cervical corpectomy and fusion (ACCF) procedures per year; 35 % do 5-20 per year. Anterior cervical discectomy and fusion (ACDF) was preferred by 41 % of the participants to laminoplasty/laminectomy (19 %/16 %) and ACCF (12 %). Most indications for ACCF involved degenerative (27 %), traumatic (17 %), and neoplastic (20 %) conditions. Intraoperative and postoperative complications were mainly associated with hardware failure. One-third of the surgeons tend to use an additional dorsal approach to increase the corpectomy construct's stability for either two-level or three-level corpectomies. CONCLUSIONS: There is no current consensus in central Europe on the treatment of complex cervical disease and cervical corpectomy. The procedure is still rare, and the need for additional dorsal fixation is unclear. Further studies are needed in order to establish evidence-based standards for patient care.
Authors: Luca Papavero; Gregor Schmeiser; Ralph Kothe; Bronek Boszczyk; Oliver Heese; Yoshiharu Kawaguchi; Anna MacDowall; Claes Olerud; Nikolaos Paidakakos; Anastasios Panagiotou; Tobias Pitzen; Marcus Richter; K Daniel Riew; Aaron Stevenson; Lee Tan; Ryo Ueshima; Y H Yau; Michael Mayer Journal: Neurospine Date: 2019-07-09
Authors: Charles Tatter; Oscar Persson; Gustav Burström; Erik Edström; Adrian Elmi-Terander Journal: Oper Neurosurg (Hagerstown) Date: 2020-12-15 Impact factor: 2.703