Preliminary Surgical Result of Cervical Spine Reconstruction with a Dynamic Plate and Titanium Mesh Cage

ABSTRACT

OBJECTIVE: The objective of this study was to validate the effects of a titanium mesh cage and dynamic plating in anterior cervical stabilization after corpectomy. METHODS: A retrospective study was performed on 31 consecutive patients, who underwent anterior cervical reconstruction with a titanium mesh cage and dynamic plating, from March 2004 to February 2006. Twenty-four patients had 1-level and 7 had 2-level corpectomies. Ten patients underwent surgery with a cage of 10-mm diameter and 21 with 13-mm diameter. Neurological status and outcomes were assessed according to Odom's criteria. Sagittal angle, coronal angle, settling ratio, sagittal displacement, and cervical lordosis were used to evaluate the radiological outcomes. RESULTS: In overall, 26 (83.9%) of 31 showed excellent or good outcomes. Thirteen percent (4 cases) of the patients developed surgical complications, such as hoarseness, transient dysphagia, or nerve root palsy. Seven (22.6%) patients had reconstruction failure 5 (20.8%) in the 1-level corpectomy group and 2 (28.5%) in the 2-level corpectomy group. Revisions were required in 2 patients with plate pullout due to significant instability. However, none of 5 patients who demonstrated cage displacement or screw pullout, underwent a revision. Radiographs revealed bony consolidation in 96.3% of the patients, including 6 patients with implantation failure during the follow-up period. CONCLUSION: Based on our preliminary results, the titanium mesh cage and dynamic plating was effective for cervical reconstruction after corpectomy. The anterior cervical reconsrtruction performed with dynamic plates is considered to reduce stress shielding and greater graft compression that is afforded by the unique plate design.