Corpectomy and Vertebral Body Reconstruction with Expandable Cage Placement and Osteosynthesis via the single stage Posterior Approach: a Retrospective Series of 34 Patients with Thoracic and Lumbar Spine Vertebral Body Tumors

Joubert, Christophe; Adetchessi, T.; Peltier, Émilie; Graillon, Thomas; Dufour, Henry; Blondel, Benjamin; Fuentès, S.

doi:10.1016/j.wneu.2015.06.072

Cited by 25 publications

(11 citation statements)

References 28 publications

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“…Several clinical studies have shown the efficacy of the expandable cage, mostly in the cervical spine [2][3][4][5][6][7]10,[15][16][17][18][19][20][21]. Most common indications were, similar to our study, cervical spinal canal stenosis [7,12], metastases [5,10,17], fractures [2,6] and spondylodiscitis [4,19].…”

Section: Discussionsupporting

confidence: 81%

Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients

et al. 2020

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Background and objectives: Expandable cages are frequently used to reconstruct the anterior spinal column after a corpectomy. In this retrospective study, we evaluated the perioperative advantages and disadvantages of corpectomy reconstruction with an expandable cage. Materials and Methods: Eighty-six patients (45 male and 41 female patients, medium age of 61.3 years) were treated with an expandable titanium cage for a variety of indications from January 2012 to December 2019 and analyzed retrospectively. The mean follow-up was 30.7 months. Outcome was measured by clinical examination and visual analogue scale (VAS); myelopathy was classified according to the EMS (European Myelopathy Scale) and gait disturbances with the Nurick score. Radiographic analysis comprised measurement of fusion, subsidence and the C2–C7 angle. Results: Indications included spinal canal stenosis with myelopathy (46 or 53.5%), metastasis (24 or 27.9%), spondylodiscitis (12 or 14%), and fracture (4 or 4.6%). In 39 patients (45.3%), additional dorsal stabilization (360° fusion) was performed. In 13 patients, hardware failure occurred, and in 8 patients, adjacent segment disease occurred. Improvement of pain symptoms, myelopathy, and gait following surgery were statistically significant (p < 0.05), with a medium preoperative VAS of 8, a postoperative score of 3.2, and medium EMS scores of 11.3 preoperatively vs. 14.3 postoperatively. Radiographic analysis showed successful fusion in 74 patients (86%). As shown in previous studies, correction of the C2–C7 angle did not correlate with improvement of neurological symptoms. Conclusion: Our results show that expandable titanium cages are a safe and useful tool in anterior cervical corpectomies for providing adequate anterior column support and stability.

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Section: Discussionsupporting

confidence: 81%

Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients

et al. 2020

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“…Pseudarthrosis and implant failure rates requiring reoperation following open thoracic corpectomy with cage reconstruction are generally low, with reported rates ranging from 0% to 10%. [7][8][9]15,22 These failure rates are likely dependent on the time point of follow-up, as we have demonstrated higher rates of implant failure with longer follow-up. Nonetheless, in our study, the implant failure rates following mini-open corpectomy and percutaneous instrumentation without fusion at 6, 12, and 24 months (0.0%, 6.2%, and 8.3%, respectively) fall within the range of previously reported implant failure rates after open surgery with fusion.…”

Section: Discussionmentioning

confidence: 69%

Minimally invasive instrumentation without fusion during posterior thoracic corpectomies: a comparison of percutaneously instrumented nonfused segments with open instrumented fused segments

Lau

Chou

2017

Journal of Neurosurgery: Spine

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OBJECTIVEDuring the mini-open posterior corpectomy, percutaneous instrumentation without fusion is performed above and below the corpectomy level. In this study, the authors' goal was to compare the perioperative and long-term implant failure rates of patients who underwent nonfused percutaneous instrumentation with those of patients who underwent traditional open instrumented fusion.METHODSAdult patients who underwent posterior thoracic corpectomies with cage reconstruction between 2009 and 2014 were identified. Patients who underwent mini-open corpectomy had percutaneous instrumentation without fusion, and patients who underwent open corpectomy had instrumented fusion above and below the corpectomy site. The authors compared perioperative outcomes and rates of implant failure requiring reoperation between the open (fused) and mini-open (unfused) groups.RESULTSA total of 75 patients were identified, and 53 patients (32 open and 21 mini-open) were available for followup. The mean patient age was 52.8 years, and 56.6% of patients were male. There were no significant differences in baseline variables between the 2 groups. The overall perioperative complication rate was 15.1%, and there was no significant difference between the open and mini-open groups (18.8% vs 9.5%; p = 0.359). The mean hospital stay was 10.5 days. The open group required a significantly longer stay than the mini-open group (12.8 vs 7.1 days; p < 0.001). Overall implant failure rates requiring reoperation were 1.9% at 6 months, 9.1% at 1 year, and 14.7% at 2 years. There were no significant differences in reoperation rates between the open and mini-open groups at 6 months (3.1% vs 0.0%, p = 0.413), 1 year (10.7% vs 6.2%, p = 0.620), and 2 years (18.2% vs 8.3%, p = 0.438). The overall mean follow-up was 29.2 months.CONCLUSIONSThese findings suggest that percutaneous instrumentation without fusion in mini-open transpedicular corpectomies offers similar implant failure and reoperation rates as open instrumented fusion as far out as 2 years of follow-up.

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“…VBR subsidence is the major complication after TES (accounting for 63% of all complications) [33] and can lead to instrumentation failure [9,10]. Better results have been achieved by increasing the surface area of the VBR and enlarging the contact area with the endplate to alleviate stress concentration [34,35]. In addition to increasing control of the VBR and enhancing system stability, short-segment posterior xation with an arti cial pedicle was shown to reduce the subsidence of cancellous bone by 50% [11].…”

Section: Discussionmentioning

confidence: 99%

Biomechanics of artificial pedicle fixation in a 3D-printed prosthesis after total en bloc spondylectomy: A finite element analysis

Wang

Ye³

et al. 2021

Preprint

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Background: This study compared the biomechanics of artificial pedicle fixation in spine reconstruction with a 3-dimensional (3D)-printed prosthesis after total en bloc spondylectomy (TES) by finite element analysis.Methods: A thoracolumbar (T10–L2) finite element model was developed and validated. Two models of T12 TES were established in combination with different fixation methods: Model A consisted of long-segment posterior fixation (T10/11, L1/2) + 3D-printed prosthesis; and Model B consisted of Model A + two artificial pedicle fixation screws. The models were evaluated with an applied of 7.5 N·m and axial force of 200 N. We recorded and analyzed the following: 1) stiffness of the two fixation systems; 2) hardware stress in the two fixation systems; and 3) stress on the endplate adjacent to the 3D-printed prosthesis.Results: The fixation strength of Model B was enhanced by the screws in the artificial pedicle, which was mainly manifested as an improvement in rotational stability. The stress transmission of the artificial pedicle fixation screws reduced the stress on the posterior rods and endplate adjacent to the 3D-printed prosthesis in all directions of motion, especially in rotation.Conclusions: After TES, the posterior long-segment fixation combined with the anterior 3D printed prosthesis could maintain postoperative spinal stability, but adding artificial pedicle fixation increased the stability of the fixation system and reduced the risk of prosthesis subsidence and instrumentation failure.

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Corpectomy and Vertebral Body Reconstruction with Expandable Cage Placement and Osteosynthesis via the single stage Posterior Approach: a Retrospective Series of 34 Patients with Thoracic and Lumbar Spine Vertebral Body Tumors

Cited by 25 publications

References 28 publications

Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients

Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients

Minimally invasive instrumentation without fusion during posterior thoracic corpectomies: a comparison of percutaneously instrumented nonfused segments with open instrumented fused segments

Biomechanics of artificial pedicle fixation in a 3D-printed prosthesis after total en bloc spondylectomy: A finite element analysis

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