Anterior Lumbar Corpectomy with Expandable Titanium Cage Reconstruction: A Case Sequence of 42 Sufferers.
World Neurosurg. 2017 Dec;108:317-324
Authors: Richardson B, Paulzak A, Rusyniak WG, Martino A
BACKGROUND: Burst fractures contain the anterior and center columns with an intact posterior column. Deforming forces are magnified at areas of transition, making the thoracolumbar junction extremely vulnerable to damage.
METHODS: This can be a retrospective evaluate of 42 consecutive sufferers who underwent single-level anterior lumbar corpectomy utilizing an obelisc expandable titanium cage and lateral fixation for traumatic lumbar burst fractures.
RESULTS: Myelopathy and sensory dysfunction had been essentially the most frequent neurologic deficits initially, occurring in 16 (38%) and 15 (36%) sufferers, respectively, which each decreased to five (13%). At follow-up, 26 sufferers (68%) had been capable of ambulate independently. No affected person had important cage displacement or wanted cage substitute. Subsidence was minimal in 32 of 39 sufferers (82%). There have been no infections or surgical web site infections. Choices for stabilization embody posterior instrumentation and fusion, anterior corpectomy with interbody fusion, and mixture procedures. We imagine anterior stabilization is superior as a result of the purpose is structural restoration of anterior and center columns. The purpose of posterior fixation is to switch the posterior stress band, which isn’t affected. There are three main surgical parts to contemplate. First is anterior versus posterior decompression of the spinal canal. Second is the selection of autograft or titanium graft. Third is whether or not to stabilize posteriorly or anterolateral.
CONCLUSIONS: Anterior corpectomy with an expandable titanium cage and lateral rod fixation is secure and efficient with minimal problems. It’s a viable different to posterior decompression and instrumentation.
PMID: 28887282 [PubMed – indexed for MEDLINE]