STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess the subsidence and revision rates associated with different interbody cages following anterior cervical corpectomy and reconstruction. SUMMARY OF BACKGROUND DATA: Different interbody cages are currently used for surgical reconstruction of the anterior and middle columns of the spine following anterior cervical corpectomy. However, subsidence and delayed union/nonunion associated with allograft and cage reconstruction are common complications, which may require revision with instrumentation. MATERIALS AND METHODS: We reviewed the cases of 75 patients who underwent cervical corpectomy and compared the radiographic graft subsidence and revision rates for fibula allograft, titanium mesh cage, titanium expandable cage, and carbon fiber cages. Subsidence was calculated by comparing the immediate postoperative lateral x-ray films to those obtained during follow-up visits. RESULTS: The average graft subsidence was 3 mm and revision rate was 25% for fibula allograft versus 2.9 mm and 11.1%, 2.9 mm and 18.8% for titanium mesh cages and titanium expandable cages, respectively. The average graft subsidence for carbon fiber cages was 0.7 mm with no revision surgery in this subset. CONCLUSIONS: Our findings suggest that subsidence and revision rates following anterior corpectomy and interbody fusion could be minimized with the use of a carbon fiber cage.
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess the subsidence and revision rates associated with different interbody cages following anterior cervical corpectomy and reconstruction. SUMMARY OF BACKGROUND DATA: Different interbody cages are currently used for surgical reconstruction of the anterior and middle columns of the spine following anterior cervical corpectomy. However, subsidence and delayed union/nonunion associated with allograft and cage reconstruction are common complications, which may require revision with instrumentation. MATERIALS AND METHODS: We reviewed the cases of 75 patients who underwent cervical corpectomy and compared the radiographic graft subsidence and revision rates for fibula allograft, titanium mesh cage, titanium expandable cage, and carbon fiber cages. Subsidence was calculated by comparing the immediate postoperative lateral x-ray films to those obtained during follow-up visits. RESULTS: The average graft subsidence was 3 mm and revision rate was 25% for fibula allograft versus 2.9 mm and 11.1%, 2.9 mm and 18.8% for titanium mesh cages and titanium expandable cages, respectively. The average graft subsidence for carbon fiber cages was 0.7 mm with no revision surgery in this subset. CONCLUSIONS: Our findings suggest that subsidence and revision rates following anterior corpectomy and interbody fusion could be minimized with the use of a carbon fiber cage.
Authors: Derek T Cawley; Abdulmajeed Alzakri; Takashi Fujishiro; David C Kieser; Celeste Tavalaro; Louis Boissiere; Ibrahim Obeid; Vincent Pointillart; Jean Marc Vital; Olivier Gille Journal: J Spine Surg Date: 2019-06