Efficacy of Titanium Mesh Cages for Anterior Column Reconstruction after Thoracolumbar Corpectomy

Abdeen, Khaled

Abstract

STUDY DESIGN: This retrospective study was conducted to determine the safety and efficacy of titanium cage reconstruction and anterior plating after thoracolumbar corpectomy. PURPOSE: To study the clinical and radiological outcome of anterior column reconstruction after thoracolumbar corpectomy. OVERVIEW OF LITERATURE: Anterior column reconstruction aims to optimize neural decompression with adequate stabilization.
METHODS
A series of 16 patients underwent reconstruction after thoracolumbar corpectomy to treat injury due to trauma (n=10), tuberculosis (n=3), and tumor (n=3). The average duration of follow-up was 18 months (range, 8-58 months). The degree of kyphosis, construct height, and the subsidence of the cage in relation to the vertebral endplates were measured. The approach was thoracoabdominal in 10 cases and retroperitoneal in 6 cases.
RESULTS
Four patients were neurologically intact with Frankel grade E on admission, and all remained intact postoperatively. Of the 6 patients with Frankel grade D, all fully recovered full motor and sensory functions. Of the 6 patients with Frankel grade C, three improved one grade and the other three improved two grades. The mean height of the vertebra before surgery was 41 mm and the mean construct height immediately after surgery and at follow-up was 47 mm and 44 mm, respectively. Solid fusion was observed in all patients. The sagittal alignment of the fractured segment was restored immediately after surgery as a significant decrease in the local kyphotic angle.
CONCLUSIONS
Anterior instrumentation is an effective and safe treatment for thoracolumbar instability with satisfactory clinical and radiological outcomes.