Ceramic vertebral body replacement for metastatic spine tumors.

A modular ceramic spacer system was developed and used for vertebral body replacement in 21 patients with metastatic spine tumor in cervical (n = 10 cases), thoracic (n = 9), and lumbar spines (n = 2). All cases of cervical and lumbar spinal tumors underwent simultaneous use of a ceramic spacer and plate-screw fixation, and eight patients received additional posterior interventions in the thoracic spine. Postoperative radiation therapy was performed in all cases except two, which involved prostatic carcinoma. Complete or moderate pain relief was obtained in 19 patients, and 17 patients were able to walk after surgery. The average bed rest period was 11 days. Radiologically, a clear zone at the spacer-vertebral body interfaces and migration of the spacer was observed in four cases and one case, respectively. However, satisfactory pain relief and stabilization of the spine was obtained in an average follow-up time of 22.3 months. In all four autopsy specimens studied, the ceramic spacer showed firm connection with the vertebral body. This modular ceramic spacer system facilitates a relatively easy procedure, maintenance of spinal stability, early ambulation, and no interference with local radiation therapy.