New Surgical Technique to Secure the Bone Strut During Anterior Cervical Corpectomy and Fusion: Kusabi Fixation Technique -Technical Note-

Abstract

Fixation using an anterior cervical plate is frequently used in anterior cervical discectomy or corpectomy and fusion procedures because of the higher fusion rate than without instrumentation. The surgical outcomes with the anterior plate technique are acceptable, but various hardware-related complications have been reported. The authors describe a new surgical technique, called the kusabi fixation technique, for securing the bone strut during anterior cervical corpectomy using cylindrical cages. Following corpectomy, the trimmed bone strut was placed into the space drilled-out. Two small holes of 5-6-mm diameter and 5-mm depth were drilled out at the interface of two bones at the top and bottom of the bone strut in a diagonal orientation. Two cylindrical cages filled with autologous bone tips were tapped into the interface. Eight patients with myelopathy were treated by this method. All procedures were uneventfully performed as a single level surgery (two vertebral bodies and one disk level). Solid bone union was obtained in all patients at 6 months after the operation. Apparent alignment change in the cervical spine was observed in only one patient, who developed asymptomatic kyphosis. No instrumentation failure or significant complications related to the surgery occurred. Precise biomechanical aspects and long-term radiographic analysis compared with the plate fixation technique should be established, but this new method provides another way to secure the bone strut in anterior cervical corpectomy and fusion.