Vertebrectomy and anterior reconstruction for the treatment of spinal metastases.

The purpose of this study was to retrospectively analyse the outcome of modular vertebral body replacement in conjunction with vertebrectomy in cancer patients with skeletal metastases. Between 1996 and 2000, we performed vertebrectomy with subsequent implantation of a modular vertebral body replacement in 24 patients with skeletal metastases of the spine. The findings were analysed retrospectively. The mean postoperative survival period for all patients was 15.6 months. Improvement of preoperative back pain was achieved in 85%. Remission of initial neurological symptoms based on the Frankel classification was achieved in 57.1% of the patients. Implant dislocations were not observed during follow-up. Vertebrectomy for vertebral metastasis is indicated in selected patients. Type of underlying malignancy, metastatic spread and adjuvant treatment options are an important basis for the indication. In anterior defect reconstructions, modular implants can directly restore stability while reducing tumour-related symptoms.

Circumferential fusion of the lumbar and lumbosacral spine using a carbon fiber ALIF cage implant versus autogenous bone graft: a comparative study.

This study reports on 92 patients treated with circumferential lumbar fusions for degenerative conditions. The elected procedure was a circumferential fusion using transpedicular stabilization. Two groups were examined depending on whether they were stabilized anteriorly with autogenous bicortical iliac crest graft (n = 38) or with an ALIF carbon fiber cage implant (n = 54). The patients were evaluated for clinical and radiographic outcome. The minimum follow-up interval was at least 12 months. Fusion rates, postoperative loss of correction, and clinical results, including pain at the bone donor site, neurologic function, satisfaction, depression, and consumption of analgesics, were not significantly different between patients with autogenous bone graft and patients with carbon cage. This study failed to prove major advantages of the carbon cages in the clinical and radiologic outcome.