MedWorm: Cervical Corpectomy

Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome.

Neurosurgical Focus — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions . These results demonstrate that both anterior and posterior decompression (with instrumentation) are effective procedures to improve the neurological outcome of patients with CSM. However, sagittal alignment may be better restored using the anterior approach, but harbors a higher rate of loss of correction. In cases involving a preexisting cervical kyphosis, an anterior or combined approach might be necessary to restore the lordotic cervical alignment. PMID: 20192660 [PubMed - in process] (Source: Neurosurgical Focus)

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Noncontiguous anterior decompression and fusion for multilevel cervical spondylotic myelopathy: a prospective randomized control clinical study

European Spine Journal — Sat, 20 Feb 2010 06:51:32 +0100

In conclusion, in the patients with MCSM, without developmental stenosis and continuous or combined ossification of posterior longitudinal ligaments, NADF and CCF showed an identical effect of decompression. In terms of surgical time, blood loss, VAS, fusion rate and cervical alignment, NADF was superior compared with CCF. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00586-010-1319-8Authors Xiao-Feng Lian, Sixth People’s Hospital, Shanghai Jiaotong University Department of Orthopedics Shanghai ChinaJian-Guang Xu, Sixth People’s Hospital, Shanghai Jiaotong University Department of Orthopedics Shanghai ChinaBing-Fang Zeng, Sixth People’s Hospital, Shanghai Jiaotong University Department of Orthopedics Shanghai ChinaWei Zhou, Sixth People’s Hospital, Shan...

The use of expandable cages in patients undergoing multilevel corpectomies for metastatic tumors in the cervical spine.

Orthopedics — Mon, 01 Feb 2010 00:00:00 +0100

We report our experience with the use of expandable cages in this subgroup of patients.From August 2006 to May 2008, 5 patients presenting with myelopathy, pain, and/or radiculopathy secondary to metastatic disease of the cervical spine underwent multilevel cervical corpectomies and placement of expandable cages in our institution. All procedures were supplemented with an anterior cervical plate and with posterior instrumentation to achieve a 360 degrees fusion. A visual analog scale (VAS), Nurick grade, Frankel grade, American Spinal Injuries Association (ASIA) grade, and Ranawat grade were used to evaluate patients pre- and postoperatively. The mean follow-up period was 13.2 months. Three patients underwent a 2-level corpectomy, 1 a 3-level corpectomy, and 1 a 4-level corpectomy. Postope...

"Skip" corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament.

Journal of Neurosurgery.Spine — Fri, 01 Jan 2010 00:00:00 +0100

Conclusions The authors conclude that the preservation of the C-5 vertebral body provided an additional screw purchase and strengthened the construct. The results of the current study demonstrated effectiveness and safety of the skip corpectomy in patients with multilevel CSM and OPLL. PMID: 20043761 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia

European Spine Journal — Fri, 11 Dec 2009 06:52:38 +0100

In conclusion, surgeons should consider the potential for CDH when performing spinal cord decompression and deciding the surgical approach in patients presenting with OPLL. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00586-009-1239-7Authors Hai-song Yang, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaDe-yu Chen, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaXu-hua Lu, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaLi–li Yang, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang Road 200003 Shanghai ChinaWang-jun Yan, Changzheng Hospital Department of Orthopaedic Surgery No. 415 Feng Yang R...

Comparison of anterior cervical fusion after two-level discectomy or single-level corpectomy: sagittal alignment, cervical lordosis, graft collapse, and adjacent-level ossification

The Spine Journal — Thu, 22 Oct 2009 00:00:00 +0100

Abstract: Background context: Single-level corpectomy and two-level discectomy with anterior cervical plating have been reported to have comparable fusion and complication rates. However, there are few large series that have compared the two for sagittal alignment, cervical lordosis, graft subsidence, and adjacent-level ossification.Purpose: To determine the differences between these two procedures for patients with two-level spondylosis by comparing the pre- and postoperative radiographic data.Study design: Retrospective review of prospectively collected data in an academic institution.Patient sample: Fifty-two with a single-level corpectomy and 45 with a two-level anterior cervical discectomy and fusion (ACDF).Outcome measures: Pre- and postoperative radiographic data for sagittal alignm...

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Pseudomorbidity in iliac crest bone graft harvesting: the rise of rhBMP-2 in short-segment posterior lumbar fusion

The Spine Journal — Wed, 21 Oct 2009 14:03:56 +0100

In this study, it is clear that the autologous technique has serious and frequent problems. The other two studies in this issue look at the most common cited complication associated with posterior iliac crest bone graft (ICBG) harvesting, pain. (Source: The Spine Journal)

Posterior transpedicular corpectomy for malignant cervical spine tumors

European Spine Journal — Tue, 13 Oct 2009 08:17:44 +0100

Abstract The goal of this study was to assess surgical clinical and radiographic outcomes of using a posterior transpedicular approach (posterolateral) for ventral malignant tumors of the cervical spine. Access to ventral lesions of the cervical spine can be challenging in patients with malignant tumors. Anterior approaches are the gold standard for ventral pathology in the cervical spine, however, there are cases, where a posterior approach is indicated due to multilevel disease, previous radiation, swallowing difficulty with difficulty in retraction of trachea and esophagus, and in cases where circumferential fusion cannot be done due to patients’ poor medical condition. A single approach could provide spinal stabilization and removal of tumor. Eight cases of ventral c...

Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study

The Spine Journal — Mon, 12 Oct 2009 00:00:00 +0100

Conclusion: This study suggests that screw divergence from the end plates not only increases load transmission to the graft but also predisposes the screws to higher shear forces after corpectomy reconstruction. In particular, the inferior screw demonstrated larger stress than the upper-level screws. In the proposed hybrid fusion model, lower stresses on the bone graft, end plates, and bone-screw interface were recorded, inferring lower construct failure (end-plate fractures and screw pullout) potential at the inferior construct end. (Source: The Spine Journal)

Quality of life assessment after central corpectomy for cervical spondylotic myelopathy: comparative evaluation of the 36-Item Short Form Health Survey and the World Health Organization Quality of Life-Bref.

Journal of Neurosurgery.Spine — Thu, 01 Oct 2009 00:00:00 +0100

Conclusions The WHOQOL-Bref, like the SF-36, is valid and reliable in assessing outcome in patients with CSM. It measures impairment in CSM in a more uniform manner than the SF-36, but its domains are less responsive to postoperative changes. Because the WHOQOL-Bref measures different constructs and has additive value, it should be used along with the SF-36 for QOL assessment in patients with CSM. PMID: 19929335 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

A combined posterior, lateral, and anterior approach to ventrolaterally situated chordoma of the upper cervical spine

Surgical Neurology — Mon, 07 Sep 2009 17:59:50 +0100

Conclusion: When a direct posterior approach makes it difficult or impossible to reach tumors extending to the far lateral margins of the spine and soft tissues, the posterior-lateral approach described here allows excellent visualization and safe access with minimal neural retraction for treating these laterally situated lesions. We describe the surgical technique for a combined approach as an alternative to the direct posterior or anterior retropharyngeal approach. (Source: Surgical Neurology)

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Brown-Sequard-type myelopathy due to cervical disc herniation associated with severe carotid stenosis prompting rapid combined corpectomy and carotid endarterectomy under deep anticoagulant therapy

The Spine Journal — Tue, 01 Sep 2009 23:00:00 +0100

Conclusions: This case suggests that such a combined carotid endarterectomy and cervical corpectomy with fusion under anticoagulant and antiplatelet therapy is feasible. However, even if the unique clinical presentation of our patient led us to undertake such a surgical strategy, therapeutic decision in patients presenting with both severe carotid stenosis and cervical spinal cord compression should rely on a case-by-case analysis. (Source: The Spine Journal)

Anterior neurodecompression of kyphotic spondylogenic myelopathy Ranawat grade III and posterior decompression of lordotic spine improve walking ability.

Collegium Antropologicum — Tue, 01 Sep 2009 00:00:00 +0100

Authors: Margetić P, Elabjer E, Milosević M, Skoro I, Milanov B, Stancić M Cervical spondylosis is common condition rarely associated with radiculomyelopathy which surgical treatment, according to meta-analysis, is not better than nonsurgical. Our hypothesis was that neurodecompression which type is chosen according to spinal alignment should result in better functional improvement comparing with nonsurgical treatment. Between January 1, 1998 and December 31, 2007 a total of 77 patients with spondylogenic myelopathy were selected for the study. The inclusion criteria were symptoms and signs of myelopathy Ranawat grade III. Exclusion criteria were amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). The curvature of the cervical spine was determined by Ishi...

Hybrid decompression technique and two-level corpectomy are effective treatments for three-level cervical spondylotic myelopathy.

J Zhejiang Univ Sci ... — Mon, 31 Aug 2009 23:00:00 +0100

Authors: Liu Y, Yu KY, Hu JH The optimal surgical strategy for multilevel cervical spondylotic myelopathy (CSM) has not been defined, and few comparative researches between hybrid decompression and multilevel corpectomy have been conducted. Here, we reported 28 patients of three-level CSM, of whom 12 underwent hybrid decompression and 16 two-level corpectomy, with each type of procedure chosen according to radiologic characteristics of those patients. Clinical and radiologic parameters of both groups showed various degrees of improvement. However, no statistically significant differences in Japanese Orthopedic Association (JOA) score improvement rate, graft fusion rate, post-operative neck disability index (NDI) or segmental lordosis between the two groups were found. We conclude that ...

Commentary

Surgical Neurology — Mon, 10 Aug 2009 00:00:00 +0100

Anterior corpectomy with direct removal of prominent OPLL and fixation is one of the most difficult and challenging procedures in cervical spine surgery. Wound-peritoneal shunt with LP shunt reported by the author is one way to deal with dural tear with CSF leakage, which is one of the annoying complications of this procedure. In my personal series of 185 cases of cervical OPLL for the last decade, only 4 cases (2.1%) needed a combined approach—which consisted of multilevel corpectomy for removal of prominent OPLL and fixation after expansive laminoplasty because of neurologic deterioration in follow-ups. Therefore, expansive laminoplasty, either open-door or double-door, is an effective and less invasive procedure with a few complications for extensive OPLL of continuous or mixed type. ...

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy

European Spine Journal — Fri, 07 Aug 2009 11:18:25 +0100

The objective of the article is to verify the hypothesis that the dorsal multilevel laminectomy and rod-screw-instrumented fusion (DLF) for multilevel spondylotic cervical myelopathy (MSCM) is less strenuous for patients, and less prone to perioperative complications, than ventral multilevel corpectomy and plate-screw-instrumented fusion (VCF), while clinical outcome is comparable. One hundred and three successive patients were treated for at least two vertebral-level MSCM, 42 of them by VCF and 61 by DLF. The two patients groups were retrospectively compared. VCF patients were slightly younger than DLF patients (62.5 ± 10.61 years versus 66 ± 12.4 years, P = 0.012). In VCF patients, a median of 2 (2–3) corpectomies and in DLF patients a med...

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Cervical surgical techniques for the treatment of cervical spondylotic myelopathy.

Journal of Neurosurgery.Spine — Fri, 31 Jul 2009 23:00:00 +0100

Conclusions Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate. PMID: 19769492 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Cervical spine lateral approach for myeloradiculopathy: technique and pitfalls

Surgical Neurology — Wed, 15 Jul 2009 23:00:00 +0100

Conclusion: The cervical lateral multilevel corpectomy/foraminotomy technique allows wide anterior decompression of the spinal cord and complete unilateral nerve root decompression preserving spinal stability and physiological spinal motion. (Source: Surgical Neurology)

Differences between subtotal corpectomy and laminoplasty for cervical spondylotic myelopathy

Spinal Cord — Tue, 14 Jul 2009 23:00:00 +0100

Authors: S Shibuya, S Komatsubara, S Oka, Y Kanda, N Arima & T Yamamoto (Source: Spinal Cord)

Differences between subtotal corpectomy and laminoplasty for cervical spondylotic myelopathy

Spinal Cord — Tue, 14 Jul 2009 23:00:00 +0100

Authors: S Shibuya, S Komatsubara, S Oka, Y Kanda, N Arima & T Yamamoto (Source: Spinal Cord)

Brucella cervical spondylitis complicated by spinal cord compression: a case report

Cases Journal — Wed, 08 Jul 2009 23:00:00 +0100

A case of 65-year-old farmer who presented with Brucella-related cervical spondylitis is described. Because of the advanced form of the infection resulted in neurological impairment, cervical vertebra corpectomy and debridement of the paravertebral granulomatous tissue deposits were performed followed by stabilization with anterior plating and bone grafting. In addition, double antimicrobial chemotherapy regimen was administered for 12 weeks. After one year, follow up evaluation demonstrated resolution of the infection. The authors recommend that brucellosis should be included in the differential diagnosis of cervical spondylitis, particularly in patients who reside in countries where the zoonosis is still endemic. (Source: Cases Journal)

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Donor-site complications of autogenous nonvascularized fibula strut graft harvest for anterior cervical corpectomy and fusion surgery: experience with 163 consecutive cases

The Spine Journal — Sun, 14 Jun 2009 23:00:00 +0100

Abstract: Background context: The fibula is a source of bone graft for reconstruction of the appendicular and axial skeleton.Purpose: The aim of this study is to determine donor-site complications and morbidity in a large series of patients who underwent autogenous fibula harvesting for anterior cervical corpectomy and fusion (ACCF) surgery.Study design/setting: Retrospective review (Level III).Patient sample: One hundred sixty-three patients over an eight-year period who underwent ACCF with autogenous fibula.Outcome measures: Donor site complications (such as infection, cellulitis, pain, damage to the superficial peroneal nerve, ankle instability, tibial stress fracture, and so forth), treatment, and final outcome were determined from patient records.Methods: Retrospective study of patien...

Diagnosis and surgery of ossification of posterior longitudinal ligament associated with dural ossification in the cervical spine

European Spine Journal — Tue, 19 May 2009 05:55:25 +0100

This study reviewed 138 patients who received anterior cervical corpectomy and fusion (ACCF) for OPLL, and 40 patients were found in the association with DO during anterior procedure. Radiological studies revealed that the patients with severe OPLL (higher occupying rate and larger extent) have increasing opportunity of association with DO. The double-layer sign, as a specific indicator for association with DO was sensitive in the patients with mild OPLL, but less frequent in those with severe OPLL with DO. Two surgical techniques were used for the patients with DO in anterior decompression procedure. When the double-layer sign was observed on CT scans, the OPLL could be separated from DO through a thin layer consisting a nonossified degenerated PLL to avoid CSF leakage. Otherwise, t...

Anterior subaxial cervical spine fixation using a plate with single screw per vertebral body: A simple and efficient construct - Clinical series and a cadaver study

Neurology India — Fri, 15 May 2009 15:14:12 +0100

Conclusion:</b> A conservative construct utilizing a single screw per vertebral body and a one-holed plate system appears to be strong enough to afford stability in both traumatic and nontraumatic lesions of subaxial cervical spine, comparable to others. (Source: Neurology India)

Functional outcome of corpectomy in cervical spondylotic myelopathy

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Thu, 07 May 2009 18:01:02 +0100

Conclusions:</b> Cervical corpectomy is a reliable and rewarding procedure for CSM, with functional improvement in most patients. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Functional outcome of corpectomy in cervical spondylotic myelopathy

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Mon, 04 May 2009 01:01:39 +0100

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Multilevel oblique corpectomy without fusion in managing cervical myelopathy: long-term outcome and stability evaluation in 268 patients.

Journal of Neurosurgery.Spine — Thu, 30 Apr 2009 23:00:00 +0100

CONCLUSIONS: Multilevel oblique corpectomy was demonstrated to be a safe procedure that provided good results in terms of improved functional status and long-term spinal stability. PMID: 19442008 [PubMed - indexed for MEDLINE] (Source: Journal of Neurosurgery.Spine)

Distal-type cervical spondylotic amyotrophy: incidence and outcome after central corpectomy.

Journal of Neurosurgery.Spine — Tue, 31 Mar 2009 23:00:00 +0100

CONCLUSIONS: Distal-type CSA is a rare form of CSM that should be differentiated from motor neuron disease on the basis of subtle sensory symptoms or signs in the upper limbs, and the presence of significant cord compression on the MR imaging. Patient outcome after central corpectomy is good and long lasting. PMID: 19441997 [PubMed - indexed for MEDLINE] (Source: Journal of Neurosurgery.Spine)

Pharyngocutaneous fistula after anterior cervical spine surgery

European Spine Journal — Sat, 28 Mar 2009 08:55:46 +0100

We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closure and esophageal exclusion with a Jpeg tube. The patient was eventually successfully treated with a three-stage procedure consisting of firstly a posterior approach to reinforce the posterior stabilization of the cervical spine that was felt to be inadequate, secondly an anterior approach with removal of all the anterior instrumentation followed by iliac crest bone graft and thirdly a superior based sternocleidomastoid flap...

Comparative study of anterior versus posterior decompression in elderly patients of cervical myelopathy with co-morbid conditions

European Journal of Orthopaedic Surgery & Traumatology — Sat, 07 Mar 2009 11:00:43 +0100

Conclusion Anterior decompression is the gold standard. However, in medically unfit patients with multi-level circumferential compression laminectomy is an equally rewarding option. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00590-009-0444-8Authors Sudeep Jain, All India Institute of Medical Sciences New Delhi 79 First Floor, Raja Garden New Delhi 110015 IndiaSaurabh Singh, All India Institute of Medical Sciences New Delhi 79 First Floor, Raja Garden New Delhi 110015 IndiaAnil Kumar Joshi, All India Institute of Medical Sciences New Delhi 79 First Floor, Raja Garden New Delhi 110015 IndiaChirayu Pamecha, Nathiba Hargovindas Lallubhai Municipal Medical College Ahmedabad Ahmedabad IndiaBharat Dave, Nathiba Hargovindas Lallubhai Municipal Medical Co...

[Clinical application of expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws.]

Journal of Southern Medical University — Sun, 01 Mar 2009 05:00:00 +0100

CONCLUSION: Unilateral open-door laminoplasty with OsteoMed M3 titanium plate and screw fixation can effectively maintain the expansion of the spinal canal and resist closure while preserving the spinal alignment and stability. This modified technique is easy to perform and is associated with a low complication rate. PMID: 19304533 [PubMed - in process] (Source: Journal of Southern Medical University)

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Spinal cord herniation after multilevel anterior cervical corpectomy and fusion for ossification of the posterior longitudinal ligament of the cervical spine.

Journal of Neurosurgery.Spine — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Min JH, Jung BJ, Jang JS, Kim SK, Jung DJ, Lee SH The authors report the case of a 52-year-old man who had undergone resection of an ossified posterior longitudinal ligament via the anterior approach. The patient experienced postoperative neurological deterioration that may have been caused by a massive cord herniation associated with a dural defect at the corpectomy site. Spinal cord herniation may develop as a complication of anterior cervical decompression. Surgeons should be alert to this condition when planning to treat cervical ossification of the ossified posterior longitudinal ligament via the anterior approach. PMID: 19320584 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Comparison between anterior cervical discectomy fusion and cervical corpectomy fusion using titanium cages for reconstruction: analysis of outcome and long-term follow-up

European Spine Journal — Fri, 13 Feb 2009 08:10:12 +0100

Abstract Retrospective comparative study of 80 consecutive patients treated with either anterior cervical discectomy fusion (ACDF) or anterior cervical corpectomy fusion (ACCF) for multi-level cervical spondylosis. To compare clinical outcome, fusion rates, and complications of anterior cervical reconstruction of multi-level ACDF and single-/multi-level ACCF performed using titanium mesh cages (TMCs) filled with autograft and anterior cervical plates (ACPs). Reconstruction of the cervical spine after discectomy or corpectomy with titanium cages filled with autograft has become an acceptable alternative to both allograft and autograft; however, there is no data comparing the outcome of multi-level ACDF and single-/multi-level ACCF using this reconstruction. We evaluated 80 ...

Long-term Follow-up After Open-window Corpectomy in Patients With Advanced Cervical Spondylosis and/or Ossification of the Posterior Longitudinal Ligament.

Journal of Spinal Disorders & Techniques — Wed, 04 Feb 2009 07:07:56 +0100

Page: 14DOI: 10.1097/BSD.0b013e31815f49feAuthors: Ozer, Ali Fahir MD *; Oktenoglu, Tunc MD *; Cosar, Murat MD +; Sasani, Mehdi MD *; Sarioglu, Ali Cetin MD * (Source: Journal of Spinal Disorders & Techniques)

Analysis of Reoperations after Surgical Treatment of Degenerative Cervical Spine Disorders: A Report on 900 Cases.

Zentralblatt fur Neurochirurgie — Tue, 03 Feb 2009 05:00:00 +0100

CONCLUSIONS: The influence of the fusion length on the revision rate was unexpectedly high. Adjacent level decompensation was neither influenced by the length of the fusion nor the performed procedure. Compared to anterior instrumentation, posterior instrumentation showed a tendency for a lower revision rate without statistical significance. However, the posterior procedures showed a high revision rate regarding to wound healing problems. PMID: 19191203 [PubMed - as supplied by publisher] (Source: Zentralblatt fur Neurochirurgie)

Posterior transpedicular corpectomy and reconstruction of the axial vertebra for metastatic tumor.

Journal of Neurosurgery.Spine — Sun, 01 Feb 2009 05:00:00 +0100

Authors: Ames CP, Wang VY, Deviren V, Vrionis FD Management of metastatic disease is a significant challenge in modern spinal surgery. Previously, radiation therapy alone was the most commonly employed treatment. Recent data, however, suggest that surgical decompression in addition to radiation therapy improves functional recovery compared with radiation therapy alone. Metastatic disease most commonly affects the thoracic spine. Over the past decade surgical treatment has changed significantly for thoracic disease, shifting from transthoracic resection and reconstruction to single-stage posterolateral approaches that allow transpedicular resection and reconstruction. In posterolateral approaches, patients are spared the morbidity associated with transcavitary approaches while receiving...

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Degenerative spondylolisthesis of the cervical spine: analysis of 58 patients treated with anterior cervical decompression and fusion

The Spine Journal — Mon, 29 Dec 2008 05:00:00 +0100

Conclusions: Degenerative spondylolisthesis is relatively common in the cervical spine. Common to all cases is facet arthropathy and neurologic compression. Anterior cervical decompression and arthrodesis appears to yield excellent union rates and neurological improvement in those patients having cervical degenerative spondylolisthesis and significant neurological sequelae who have failed nonoperative treatments. (Source: The Spine Journal)

Circumferential fusion for cervical kyphotic deformity.

Journal of Neurosurgery.Spine — Sat, 29 Nov 2008 12:07:45 +0100

Conclusions In cases of cervical kyphosis, management with decompression, osteotomy, and stabilization from both anterior and posterior approaches can restore cervical lordosis. Furthermore, such surgical techniques can produce measurable improvements in neurological function (as measured with Nurick grades and mJOA scores) and achieve high fusion rates. However, there is a significant rate of complications. PMID: 19035741 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Cervical Intradural Ventral Arachnoid Cyst Resected Via Anterior Corpectomy With Reconstruction: A Case Report.

Turkish Neurosurgery — Fri, 26 Sep 2008 17:06:20 +0100

CONCLUSION: For purely ventral cervical intradural arachnoid cysts, which compress the spinal cord dorsally, an anterior approach can allow access to the lesion without any need for intraoperative manipulation of the spinal cord. For such cases, the anterior approach prevents the consequent risk of neurological injury due to posterior approaches. PMID: 18814111 [PubMed - as supplied by publisher] (Source: Turkish Neurosurgery)

Pharyngoesophageal diverticulum following cervical corpectomy and plating. Case report.

Journal of Neurosurgery.Spine — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Joanes V, Belinchón J This case of a pharyngoesophageal diverticulum was diagnosed 3 years after a corpectomy and fusion for a cervical fracture. The diverticulum was excised, the plate and screws were removed, and the patient was asymptomatic 3 years later. The dense scar tissue around the hardware probably caused traction on the posterior pharyngoesophageal region, followed by development of the diverticulum. The authors speculate that the malpositioning of the hardware was an irritative factor promoting such a scar. To the best of their knowledge, this is the first reported case of pharyngoesophageal diverticulum following cervical corpectomy and plating. PMID: 18928221 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Anterior approach to cervical intramedullary pilocytic astrocytoma. Case report.

Journal of Neurosurgery.Spine — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Ogden AT, Feldstein NA, McCormick PC Although there has been considerable experience with anterior approaches to ventral intradural, extramedullary, and pial-based spinal lesions, there is no information in the literature regarding the safety and feasibility of the resection of an intramedullary tumor via an anterior approach. The authors report on the gross-total resection of an intramedullary cervical pilocytic astrocytoma via a C-7 corpectomy and anterior myelotomy. The surgery proceeded without complication, and postoperatively the patient maintained the preoperative deficit of mild unilateral hand weakness but had no sensory deficits. Follow-up MR imaging at 6 months showed gross-total macroscopic resection. Selected intramedullary tumors can be safely removed via an ante...

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Correlation between change in graft height and change in segmental angle following central corpectomy for cervical spondylotic myelopathy.

Journal of Neurosurgery.Spine — Fri, 01 Aug 2008 04:00:00 +0100

Conclusions Among patients undergoing uninstrumented CC for CSM, there is a significant correlation between postoperative settling and kyphotic change across fused segments in those who had straight or kyphotic cervical spines or segments preoperatively but not in those who had lordotic cervical spines or segments preoperatively. A more vigorous surgical correction of the segmental kyphosis than achieved in this study might have caused the kyphotic segments to behave like the lordotic segments. Paraspinal muscles and ligaments may play a role in determining the segmental angle as graft settling in patients with lordotic spines or segments is not linearly correlated with angular change. PMID: 18764748 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Surgical treatment of cervical spondylotic myelopathy with anterior compression: a review of 67 cases.

Journal of Neurosurgery.Spine — Fri, 01 Aug 2008 04:00:00 +0100

Conclusions Significant improvement in Nurick grade can be achieved in patients who undergo anterior surgery for cervical myelopathy for primarily ventral disease or loss of cervical lordosis. In selected high-risk patients who undergo multilevel ventral decompression, supplemental posterior fixation and arthrodesis allows for low rates of construct failure with acceptable added morbidity. PMID: 18764747 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Effects of Disc Height and Distractive Forces on Graft Compression in an Anterior Cervical Corpectomy Model.

Spine — Sat, 31 May 2008 14:45:59 +0100

The role of defect and graft size on compressive loading of strut grafts was tested in 17 cadaveric cervical specimens using a calibrated Caspar distractor and subminiature load cells. Although defect size did not predict graft loading, increases in strut graft height led to significant increases in graft compressive loads.Page: 1438DOI: 10.1097/BRS.0b013e318175c315Authors: Truumees, Eeric MD +; Demetropoulos, Constantine K. PhD +; Yang, King H. PhD *; Herkowitz, Harry N. MD + (Source: Spine)

Long-term Biomechanical Stability and Clinical Improvement After Extended Multilevel Corpectomy and Circumferential Reconstruction of the Cervical Spine Using Titanium Mesh Cages.

Journal of Spinal Disorders & Techniques — Tue, 06 May 2008 20:04:41 +0100

Page: 165DOI: 10.1097/BSD.0b013e3180654205Authors: Acosta, Frank L. Jr MD; Aryan, Henry E. MD; Chou, Dean MD; Ames, Christopher P. MD (Source: Journal of Spinal Disorders & Techniques)

Cerebrospinal Fluid Leaks Following Cervical Spine Surgery

JBJS [Am] — Thu, 01 May 2008 04:00:00 +0100

Conclusions: Many cervical dural tears can be managed by observation alone or by placement of a lumbar cerebrospinal fluid shunt either during the index procedure or in the postoperative period. At an average follow-up of 5.4 years, there were no long-term sequelae of the cervical dural tears in our series. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence. (Source: JBJS [Am])

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Cervical fusion.

Journal of Neurosurgery.Spine — Thu, 01 May 2008 04:00:00 +0100

Conclusions The anticipated fusion rate is one of several factors that may guide surgical decision making. Anterior cervical decompression and fusion results in high fusion rates. The results of the authors' study show that regardless of the number of levels fused, the use of an anterior cervical plate system significantly increases the fusion rate. For two-disc-level disease, there was no significant difference between ACD with a plate system or corpectomy with a plate system. For three-disc-level disease, however, the evidence suggests that corpectomy with plate placement is associated with higher fusion rates than discectomy with plate placement. PMID: 18447700 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

Cerebrospinal fluid leaks following cervical spine surgery.

The Journal of Bone and Joint Surgery. American volume — Thu, 01 May 2008 04:00:00 +0100

CONCLUSIONS: Many cervical dural tears can be managed by observation alone or by placement of a lumbar cerebrospinal fluid shunt either during the index procedure or in the postoperative period. At an average follow-up of 5.4 years, there were no long-term sequelae of the cervical dural tears in our series. PMID: 18451403 [PubMed - indexed for MEDLINE] (Source: The Journal of Bone and Joint Surgery. American volume)

Anterior pedicle screw fixation for multilevel cervical corpectomy and spinal fusion

Acta Neurochirurgica — Wed, 23 Apr 2008 16:19:50 +0100

Conclusions. The insertion of APSs is feasible and safe. APS fixation enables us to obtain rigid fixation anteriorly, and we propose that APS fixation is an attractive option for multilevel cervical corpectomy and fusion. Content Type Journal ArticleCategory Technical NoteDOI 10.1007/s00701-008-1574-1Authors M. Aramomi, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery Chuo-ku Chiba JapanY. Masaki, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery Chuo-ku Chiba JapanS. Koshizuka, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery Chuo-ku Chiba JapanR. Kadota, Chiba University Graduate School of Medicine Spine Section, Department of Orthopaedic Surgery...

Cervical spondylotic myelopathy treated by oblique corpectomy: a prospective study.

Neurosurgery — Sat, 19 Apr 2008 07:36:09 +0100

Page: 674DOI: 10.1227/01.neu.0000317316.56235.a7Authors: Kiris, Talat M.D.; Kilincer, Cumhur M.D. (Source: Neurosurgery)

Anterior corpectomy and fusion for severe ossification of posterior longitudinal ligament in the cervical spine

International Orthopaedics — Sat, 12 Apr 2008 09:28:17 +0100

Abstract Between May 2002 and October 2006, 19 patients (17 men and 2 women; average age 57.2; range 47–71 years) received anterior corpectomy and fusion for severe ossification of the posterior longitudinal ligament (OPLL) in our department. Preoperative radiological evaluation showed the narrowing by the OPLL exceeded 50% in all cases, and OPLL extended from one to three vertebrae. We followed-up all patients for 12–36 months (mean 18 months). The Japanese Orthopaedic Association (JOA) score before surgery was 9.3 ± 1.8 (range 5–12) which significantly increased to 14.2 ± 1.3 (range 11–16) points at the last follow-up (P < 0.01). The improvement rate (IR) of neurological function ranged from 22.2–87.5%, with a mean of 63.2% ± ...

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Laser-Assisted Anterior Cervical Corpectomy versus Posterior Laminoplasty for Cervical Myelopathic Patients with Multilevel Ossification of the Posterior Longitudinal Ligament

Photomedicine and Laser Surgery — Sun, 16 Mar 2008 17:10:45 +0100

This study reports on the comparative results of a series of patients with multilevel cervical ossification of the posterior longitudinal ligament (OPLL) who were treated with laser-assisted anterior corpectomy or laminoplasty. ... (Source: Photomedicine and Laser Surgery)

Anterior corpectomy approach for removal of a cervical intradural schwannoma.

The Canadian Journal of Neurological Sciences — Sat, 01 Mar 2008 05:00:00 +0100

Authors: Casha S, Xie JC, Hurlbert RJ PMID: 18380288 [PubMed - indexed for MEDLINE] (Source: The Canadian Journal of Neurological Sciences)

Anterior Corpectomy With Iliac Bone Fusion or Discectomy With Interbody Titanium Cage Fusion for Multilevel Cervical Degenerated Disc Disease.

Journal of Spinal Disorders & Techniques — Thu, 29 Nov 2007 01:32:01 +0100

Page: 565DOI: 10.1097/BSD.0b013e318036b463Authors: Hwang, Shiuh-Lin MD, PhD *; Lee, Kung-Shing MD *; Su, Yu-Feng MD *; Kuo, Tai-Hung MD +; Lieu, Ann-Shung MD *; Lin, Chih-Lung MD *; Howng, Shen-Long MD, PhD *; Hwang, Yan-Feng MD * (Source: Journal of Spinal Disorders & Techniques)

Mediastinal migration of distal occipito-thoracic instrumentation

European Spine Journal — Wed, 14 Nov 2007 15:30:49 +0100

We present the occurrence and management of mediastinal migration of the distal aspect of a posterior occipito-thoracic screw–rod construct. No similar occurrence was found in the literature. This event occurred following an emergency tracheotomy (requiring neck hyperextension) in a patient with severe rheumatoid arthritis, who had previously undergone decompression and an Occiput-T2 instrumented fusion for cranio-cervical and sub-axial cervical spine instability. Imaging showed fracture-subluxation of T1/2 and T2/3 with the bilateral C7, T1 and T2 screws in the mediastinum causing tracheal and esophageal compression. Removal of the instrumentation, decompression (T2 corpectomy) and construct revision down to T10 was safely performed from a posterior approach. Severe osteoporosis, ...

Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

European Spine Journal — Wed, 31 Oct 2007 14:45:18 +0100

Abstract Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications of anterior corpectomy in aged patients with cervical myelopathy. Twenty patients 70 years of age or older who underwent anterior corpectomy, titanium mesh cage (TMC) reconstruction and anterior plate fixation for the treatment of compressive cervical myelopathy were reviewed. The average age at the time of operation was 75 years. Neurologic deficits before and aft...

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Multilevel Cervical Oblique Corpectomy in the Treatment of Ossified Posterior Longitudinal Ligament in the Presence of Ossified Anterior Longitudinal Ligament.

Spine — Sat, 15 Sep 2007 00:50:13 +0100

We describe the utility of the oblique corpectomy in 3 patients who presented with cervical myelopathy caused by OPLL in whom a coexistent OALL was asymptomatic. The oblique corpectomy, by virtue of its anterolateral approach, facilitated the removal of the OPLL while preserving the OALL, thus avoiding complex reconstructive procedures.Page: E575DOI: 10.1097/BRS.0b013e31814b84feAuthors: Chacko, Ari G. MCh; Daniel, Roy T. MCh (Source: Spine)

Successful treatment of extended epidural abscess and long segment osteomyelitis: a case report and review of the literature.

Surgical Neurology — Wed, 05 Sep 2007 04:00:00 +0100

CONCLUSIONS: This case illustrates that spinal instrumentation is not an absolute contraindication in the presence of epidural abscesses and vertebral osteomyelitis. Combined surgical debridement at a critical level, with adjuvant antibiotics and hyperbaric oxygenation, is a safe and effective therapy in those with neurologic deficits, spinal instability, and extended epidural abscess. PMID: 17825364 [PubMed - as supplied by publisher] (Source: Surgical Neurology)

Use of the clavicle in anterior cervical discectomy/corpectomy fusion procedures: cadaveric feasibility study

Child's Nervous System — Wed, 18 Jul 2007 06:47:34 +0100

Conclusions Based on our cadaveric study, such a bony substitute as autologous clavicle might be a reasonable alternative to the iliac crest for use in anterior cervical fusion procedures. Content TypeJournal Article JournalChild's Nervous SystemOnline ISSN 1433-0350Print ISSN 0256-7040 (Source: Child's Nervous System)

Utilization of Predonated Autologous Blood in Anterior Cervical Corpectomy and Fusion Surgery.

Journal of Spinal Disorders & Techniques — Tue, 03 Jul 2007 03:04:39 +0100

Page: 357DOI: 10.1097/BSD.0b013e31802d8383Authors: Espiritu, Michael T. MD; Khan, Mustafa H. MD; Hannallah, David MD; Donaldson, William F. III MD; Kang, James D. MD; Lee, Joon Y. MD (Source: Journal of Spinal Disorders & Techniques)

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

European Spine Journal — Fri, 29 Jun 2007 08:27:56 +0100

Abstract In the future, there will be an increased number of cervical revision surgeries, including 4- and more-levels. But, there is a paucity of literature concerning the geometrical and clinical outcome in these challenging reconstructions. To contribute to current knowledge, we want to share our experience with 4- and 5-level anterior cervical fusions in 26 cases in sight of a critical review of literature. At index procedure, almost 50% of our patients had previous cervical surgeries performed. Besides failed prior surgeries, indications included degenerative multilevel instability and spondylotic myelopathy with cervical kyphosis. An average of 4.1 levels was instrumented and fused using constrained (26.9%) and non-constrained (73.1%) screw-plate systems. At all, fou...

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Cervical Corpectomy With Preserved Posterior Vertebral Wall for Cervical Spondylotic Myelopathy: A Randomized Control Clinical Study.

Spine — Sun, 17 Jun 2007 07:05:43 +0100

A total of 178 patients with cervical spondylotic myelopathy randomly underwent corpectomy with preserved posterior vertebral wall or conventional corpectomy during a 3-year period. Surgical parameter, complication, neurologic improvement, and fusion rate in both groups were recorded and compared. It was proved that corpectomy with preserved posterior vertebral wall had decreased operative time and less blood loss against conventional corpectomy.Page: 1482DOI: 10.1097/BRS.0b013e318068b30aAuthors: Ying, Zhang MD; Xinwei, Wang MD; Jing, Zhang MD; Shengming, Xu MD; Bitao, Lv MD; Tao, Zhang MD; Wen, Yuan MD (Source: Spine)

Biomechanical Comparison of Instrumented and Uninstrumented Multilevel Cervical Discectomy Versus Corpectomy.

Spine — Mon, 14 May 2007 05:34:07 +0100

Spinal stability after multilevel corpectomy or discectomy was compared after bone graft insertion, after anterior plating, and after combined anterior and posterior instrumentation. There was little difference in stability among the techniques. An anterior plate effectively stabilized both types of decompression. Adding posterior instrumentation further reduced motion significantly.Page: 1220DOI: 10.1097/01.brs.0000270104.95045.24Authors: Galler, Robert M. DO; Dogan, Seref MD; Fifield, Mary S. BSE; Bozkus, Hakan MD; Chamberlain, Robert H. MS +; Sonntag, Volker K. H. MD; Crawford, Neil R. PhD (Source: Spine)

Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases, by M. Payer, Volume 148, Issue 11, November 2006, Pages 1173–1180

Acta Neurochirurgica — Sat, 03 Feb 2007 09:54:18 +0100

Content TypeJournal Article JournalActa NeurochirurgicaOnline ISSN 0942-0940Print ISSN 0001-6268 Journal VolumeVolume 149 Journal IssueVolume 149, Number 2 / February, 2007 (Source: Acta Neurochirurgica)

[High cervical spine injuries: classification, therapeutic indications, and surgical approaches: 286 consecutive cases]

Neurocirugia — Sun, 01 Oct 2006 04:00:00 +0100

Authors: Martín-Ferrer S Around 60% of all cervical fractures occur in the high cervical segment (C0-C1-C2); 4-15% occurs in C1, and between 15-25% in the axis. Nowadays, with high resolution imaging, we can see both anatomic and functional aspects of the fractures, as well as understand the mechanisms of injury. This can also allow us to study the evolution of the soft tissue lesions and fractures. The classification of traumatic injuries in C0-C1-C2 is basic in order to understand the mechanism of injury and natural history of these lesions. This also allow us to choose the correct or most adequate form of treatment. In the cases where surgery is indicated we must: a) release of the cord or nerves, using standard techniques such as laminectomy, discectomy or corpectomy; b) align...

Intraoperative Technique to Define the Safe Lateral Limits of Anterior Cervical Corpectomy: A Cadaveric Study.

Journal of Spinal Disorders & Techniques — Sat, 26 Aug 2006 17:39:01 +0100

(Source: Journal of Spinal Disorders & Techniques)

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Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases

Acta Neurochirurgica — Wed, 23 Aug 2006 06:34:26 +0100

Summary Background. This prospective observational study was undertaken to investigate the advantages, the safety, and the drawbacks of reconstructing a cervical corpectomy with a distractible corpectomy cage. According to the author’s literature search, this is the second clinical report on a distractible cervical corpectomy cage. Method. 20 consecutive patients underwent a single- or multi-level cervical corpectomy for spondylotic myelopathy, traumatic fracture, or tumor. The corpectomy defect was reconstructed by means of a distractible titanium cage, and local bone from the corpectomy was layed around the cage for fusion. An anterior cervical plate and/or a posterior lateral mass or pedicle screw fixation was added in all patients. The average follow-up was 14 months, a...

Successful outcome of six-level cervicothoracic corpectomy and circumferential reconstruction: case report and review of literature on multilevel cervicothoracic corpectomy

European Spine Journal — Tue, 22 Aug 2006 07:13:22 +0100

Abstract The authors report the successful outcome of a six-level corpectomy across the cervico-thoracic spine with circumferential reconstruction in a patient with extensive osteomyelitis of the cervical and upper thoracic spine. To the authors’ knowledge, this is the first report of a corpectomy extending across six levels of the cervico-thoracic spine. Clinical relevance: the authors recommend anterior cage and plate-assisted reconstruction and additional posterior instrumentation using modern spinal surgical techniques and implants. Content TypeJournal Article JournalEuropean Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

Anterior Cervical Fixation: Analysis of Load-Sharing and Stability with Use of Static and Dynamic Plates

JBJS [Am] — Mon, 03 Jul 2006 06:00:00 +0100

Conclusions: Although all of the tested anterior cervical plating systems provide similar load-sharing and stiffness following initial placement of the interbody spacer, the static plate system lost its ability to share load and limit motion following simulated subsidence of the interbody spacer. Both dynamic plate systems maintained load-sharing and stiffness despite simulated subsidence. Clinical Relevance: This study provides an improved understanding of the immediate performance of anterior cervical fusion surgery with plate fixation. (Source: JBJS [Am])

Fusion rate of anterior cervical plating after corpectomy.

Journal of Orthopaedic Surgery — Wed, 14 Dec 2005 07:00:00 +0100

CONCLUSION: The use of anterior cervical plating after anterior corpectomy and fusion with autologous bone graft greatly enhances arthrodesis. The improved fusion rate and low complication rate associated with anterior cervical plating may justify its use in the treatment of cervical spondylotic myelopathy. PMID: 16365483 [PubMed - indexed for MEDLINE] (Source: Journal of Orthopaedic Surgery)

Dynamic anterior cervical plates for multilevel anterior corpectomy and fusion with simultaneous posterior wiring and fusion: efficacy and outcomes

Spinal Cord — Tue, 29 Nov 2005 07:00:00 +0100

(Source: Spinal Cord)

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Clinical outcomes of multilevel anterior corpectomy and fusion as a revision surgery of the cervical spine: report of seven cases

Spinal Cord — Tue, 29 Nov 2005 07:00:00 +0100

(Source: Spinal Cord)