Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine
Purpose: For anterior spine column reconstruction after corpectomy, expandable cages offer solid anterior support and allow correction of deformity, providing excellent primary stability. To provide a larger body of clinical observations concerning the effectiveness of the approach, this retrospecti...
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SAGE Publishing
2020-01-01
|
Series: | Journal of Orthopaedic Surgery |
Online Access: | https://doi.org/10.1177/2309499019900472 |
id |
doaj-ba6bff237fd144229a7ae70b4f5b5537 |
---|---|
record_format |
Article |
spelling |
doaj-ba6bff237fd144229a7ae70b4f5b55372020-11-25T03:46:30ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902020-01-012810.1177/2309499019900472Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spineBarbara Cappelletto0Fabrizia Giorgiutti1Massimo Balsano2 Spine and Spinal Cord Surgical Unit, ASUIUD, Presidio Ospedaliero-Universitario Santa Maria della Misericordia di Udine, Udine, Italy Spine and Spinal Cord Surgical Unit, ASUIUD, Presidio Ospedaliero-Universitario Santa Maria della Misericordia di Udine, Udine, Italy Regional Spinal Department, UOC Ortopedia A, AOUI, Verona, ItalyPurpose: For anterior spine column reconstruction after corpectomy, expandable cages offer solid anterior support and allow correction of deformity, providing excellent primary stability. To provide a larger body of clinical observations concerning the effectiveness of the approach, this retrospective study examines patients treated by corpectomy and reconstruction with an expandable cage for different pathologies. Methods: Across 5 years, 39 patients underwent vertebral reconstruction with expandable cages after single ( n = 34), double ( n = 4), or triple ( n = 1) corpectomy. Pathologies were tumors ( n = 21), fractures, or deformities in traumatic injuries ( n = 14), degenerative pathology ( n = 2), and infection ( n = 2). Levels were cervical ( n = 10), thoracic ( n = 14), and lumbar ( n = 15). All patients were evaluated clinically and radiographically. Results: There were no cases of neurologic deterioration. Nurick grade showed significant improvement at 3 months postoperative versus preoperative ( p < 0.01). Visual analog scale significantly improved preoperatively versus 3 and 12 months postoperatively (both p = 0). Regional angulation was significantly corrected, from preoperative to 3 and 12 months postoperative, at cervical, thoracic, and lumbar levels. We achieved reconstruction of the normal local anatomy with full recovery of the height of the vertebral body. Six patients (15.4%) had complications and two (5.1%) underwent revision surgery. Conclusions: In our experience, expandable cages confer stable anterior support, providing significant improvement of the segmental kyphosis angle and restoration of the original somatic height. Our clinical results are favorable, and the low rate of complications and revision accentuates the expandable cage as a valuable tool to replace the vertebral body in diverse pathologies and different spine levels.https://doi.org/10.1177/2309499019900472 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Barbara Cappelletto Fabrizia Giorgiutti Massimo Balsano |
spellingShingle |
Barbara Cappelletto Fabrizia Giorgiutti Massimo Balsano Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine Journal of Orthopaedic Surgery |
author_facet |
Barbara Cappelletto Fabrizia Giorgiutti Massimo Balsano |
author_sort |
Barbara Cappelletto |
title |
Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine |
title_short |
Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine |
title_full |
Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine |
title_fullStr |
Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine |
title_full_unstemmed |
Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine |
title_sort |
evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine |
publisher |
SAGE Publishing |
series |
Journal of Orthopaedic Surgery |
issn |
2309-4990 |
publishDate |
2020-01-01 |
description |
Purpose: For anterior spine column reconstruction after corpectomy, expandable cages offer solid anterior support and allow correction of deformity, providing excellent primary stability. To provide a larger body of clinical observations concerning the effectiveness of the approach, this retrospective study examines patients treated by corpectomy and reconstruction with an expandable cage for different pathologies. Methods: Across 5 years, 39 patients underwent vertebral reconstruction with expandable cages after single ( n = 34), double ( n = 4), or triple ( n = 1) corpectomy. Pathologies were tumors ( n = 21), fractures, or deformities in traumatic injuries ( n = 14), degenerative pathology ( n = 2), and infection ( n = 2). Levels were cervical ( n = 10), thoracic ( n = 14), and lumbar ( n = 15). All patients were evaluated clinically and radiographically. Results: There were no cases of neurologic deterioration. Nurick grade showed significant improvement at 3 months postoperative versus preoperative ( p < 0.01). Visual analog scale significantly improved preoperatively versus 3 and 12 months postoperatively (both p = 0). Regional angulation was significantly corrected, from preoperative to 3 and 12 months postoperative, at cervical, thoracic, and lumbar levels. We achieved reconstruction of the normal local anatomy with full recovery of the height of the vertebral body. Six patients (15.4%) had complications and two (5.1%) underwent revision surgery. Conclusions: In our experience, expandable cages confer stable anterior support, providing significant improvement of the segmental kyphosis angle and restoration of the original somatic height. Our clinical results are favorable, and the low rate of complications and revision accentuates the expandable cage as a valuable tool to replace the vertebral body in diverse pathologies and different spine levels. |
url |
https://doi.org/10.1177/2309499019900472 |
work_keys_str_mv |
AT barbaracappelletto evaluationoftheeffectivenessofexpandablecagesforreconstructionoftheanteriorcolumnofthespine AT fabriziagiorgiutti evaluationoftheeffectivenessofexpandablecagesforreconstructionoftheanteriorcolumnofthespine AT massimobalsano evaluationoftheeffectivenessofexpandablecagesforreconstructionoftheanteriorcolumnofthespine |
_version_ |
1724506118143606784 |