Efficacy of Titanium Mesh Cage for Anterior Spinal Reconstruction after Thoracolumbar Corpectomy

Choi, Jae Eun; Lee, Jung Kil; Moon, Sung Jun; Kim, Soo Han

Abstract

OBJECTIVE
Destructions of vertebral body due to various etiologies including acute fracture, tumor, post-traumatic deformity and infection lead to progressive destruction of vertebral body, kyphotic deformities and further neurological deficits. Titanium mesh cages (TMCs) with cancellous autograft bone after corpectomy of the thoracolumbar spine provide immediate structural support to the anterior column. The aim of this study is to evaluate the radiological, neurological and clinical outcomes of patients with the TMCs-bone graft composite after thoracolumbar corpectomy.
METHODS
Sixteen patients underwent reconstruction using titanium mesh cages in thoracolumbar corpectomy between July 2000 and February 2005. The radiological and clinical course was documented over a mean follow up duration of 28.2 months. The degree of kyphosis, construct height and the subsidence of the cage in relation to the vertebral endplates were measured preoperatively, early postoperatively, and at the latest follow up. RESULT: The mean kyphotic angle of 3.9degrees before surgery was reduced to -2.6degrees immediately after surgery, and at the last follow up to be 3.4degrees. There was a significant difference between the preoperative versus postoperative kyphotic angle (p=0.003). The mean construct height of involved vertebra before surgery was 41.6 mm and the mean construct height immediate after surgery and at follow up were 47.9 mm and 41.5 mm, respectively. There was a significant difference between the preoperative versus postoperative construct height (p<0.0001). But there was no significant difference between the preoperative versus follow up in kyphotic angle and construct height. The mean subsidence was 5.7 mm. However, there was no case of severe collapse or significant recurrence of deformity. All patients had not attained significant neurological deterioration after surgery without major complications.
CONCLUSION
In this study, TMCs after thoracolumbar corpectomy is a successful adjunct for anterior vertebral column reconstruction. In our cases, TMCs with anterior instrumentation alone allows a good structural support and maintain spinal alignment.