Cervical spinal metastasis: anterior reconstruction and stabilization techniques after tumor resection

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>In a review of the literature, the authors provide an overview of various techniques that have evolved for reconstruction and stabilization after resection for metastatic disease in the subaxial cervical spine.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Reconstruction and stabilization of the cervical spine after vertebral body (VB) resection for metastatic tumor is an important goal in the surgical management of spinal metastasis. Generally, the VB defect is reconstructed with bone autograft or allograft, polymethylmethacrylate (PMMA), interbody spacers, and/or cages. In cases of PMMA-assisted reconstruction, internal devices are used to augment the fixation of PMMA. Stabilization is then achieved with anterior instrumentation, usually an anterior cervical locking plate. In some cases, posterior instrumentation may be necessary to supplement the anterior construct.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Anterior cervical corpectomy followed by reconstruction and stabilization is an effective strategy in the management of spinal metastases in patients.</jats:p></jats:sec>

Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae

“…These procedures can provide immediate decompression and spinal stability without associated morbidities. 2,7,9,21 Most spinal metastases are thought to occur within the vertebral body, thereby predisposing patients to pathologic fractures. 3 The risk of pathologic fracture is related to the extent of bone destruction, location of the lesion, and inherent bone quality.…”

“…In recent decades, many materials, including autografts and allografts, such as tricortical iliac bone grafts, fibular struts, surgibone, and hydroxyapatite grafts, have been used to perform anterior cervical interbody fusion. [8][9][10] Although considered the ideal fusion material, autologous iliac bone grafts are associated with donor site complications in almost 15% of patients. The extent of donor site grafts correlates directly with the frequency of harvest-related complications including numbness or pain due to femoral cutaneous injury, subcutaneous hematoma, chronic wound discomfort, and wound infection.…”

Considerations for Airway Management for Cervical Spine Surgery in Adults

“…Indications for surgery include spinal instability resulting from progressive deformity, progressive neurologic deficit, and intractable pain; the goal of surgery is to provide for pain palliation and maintain ambulatory status, and about half the patients are still alive 1 year after operation [43]. Because most lesions originate in the vertebral body, an anterior approach with corpectomy offers the most direct approach for tumor excision, canal decompression, and reconstruction of the load-bearing column; the intent is to decompress the canal at the site of the metastasis and to stabilize the spine across the involved segments [44]. Supplemental posterior instrumentation may be used if there is gross vertebral instability, a kyphotic deformity, or if the cervicothoracic junction is involved.…”

Combined treatment of metastatic renal cell carcinoma in spine

“…), на шейном и поясничном отделах операция проходила в 2 этапа: из заднего и переднего доступов (J. K. Liu, 2003 г., S. Boriani, 1994 г.) [9][10][11].…”