Abstract
Objective: To evaluate the efficacy and safety of an expandable titanium cage for anterior column replacement after partial or total corpectomy in the thoracolumbar spine.
Design: A retrospective study evaluating the clinical and radiographic outcome following insertion of a novel implant.
Subjects: Twenty-three patients with anterior column insufficiency secondary to tumour, fracture, and infection were treated with a vertebral replacement capable of rapid and controlled in-situ expansion. Follow up consisted of a clinical and radiological review at a mean of 15.2 months (range 6–20 months).
Outcome Measures: The clinical outcome was measured by the degree of pain relief post-operatively, the ability to ambulate and the reliance on walking aids. Neurological deficit was measured using the Frankel Grade. Radiological follow-up compared preoperative radiographs with those taken at maximal follow-up. The degree of kyphosis and the degree of subsidence was measured.
Results: Twenty-three patients with a mean age of 43.6 years (range 20–72) underwent surgery. Indications included metastatic tumour in eight, acute fractures in five, infection in four, degenerative conditions in three, post-traumatic kyphosis in two and pseudathrosis in one. Nineteen patients underwent a single-level corpectomy and four patients a two-level corpectomy. Fourteen patients had a significant neurological deficit preoperatively. Supplementary instrumentation was used in 20 of 23 cases (anterior in nine, posterior in eleven). Excellent pain relief was observed in 19. Ten of 14 patients showed neurological improvement. Eleven patients improved their ambulatory status. There was no hardware failure. An average correction of 110 of kyphosis was observed. The average subsidence was 1.3 mm (range 0.2–2.3).
Conclusions: The use of an expandable vertebral body replacement with supplementary instrumentation following corpectomy appears to be safe and efficacious in correcting kyphosis. This implant appears to have a high resistance to subsidence.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
