Cervical corpectomy cage [Neurosurgery Wiki]

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====== Cervical corpectomy cage ======

[[Expandable interbody cage]]s are frequently used to reconstruct the anterior [[spinal column]] after a [[corpectomy]].

In case of [[spinal cord compression]] behind the [[vertebral body]],[[ anterior cervical corpectomy and fusion]] (ACCF) proves to be a more feasible approach than [[cervical discectomy]]. The next step was the placement of an [[expandable]] [[titanium]] [[interbody]] in order to restore the vertebral height. The need for additional anterior plating with ACCF has been debatable and such technique has been evaluated by very few studies. 
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 In a [[retrospective]] study, Pojskic et al. evaluated the perioperative [[advantage]]s and [[disadvantage]]s of corpectomy [[reconstruction]] with an expandable cage.

Eighty-six patients (45 male and 41 female patients, medium age of 61.3 years) were treated with an expandable [[cervical titanium cage]] for a variety of [[indication]]s from January 2012 to December 2019 and analyzed retrospectively. The mean follow-up was 30.7 months. Outcome was measured by clinical examination and [[visual analogue scale]] ([[VAS]]); [[myelopathy]] was classified according to the EMS ([[European Myelopathy Score]]) and gait disturbances with the [[Nurick scale]]. Radiographic analysis comprised measurement of [[fusion]], [[subsidence]] and the [[C2-C7 angle]]. 

Indications included [[spinal canal stenosis]] with [[myelopathy]] (46 or 53.5%), [[metastases]] (24 or 27.9%), [[spondylodiscitis]] (12 or 14%), and [[fracture]] (4 or 4.6%). In 39 patients (45.3%), additional dorsal [[stabilization]] (360° fusion) was performed. In 13 patients, [[hardware failure]] occurred, and in 8 patients, [[adjacent segment disease]] occurred. Improvement of pain symptoms, [[myelopathy]], and [[gait]] following surgery were statistically significant (p < 0.05), with a medium preoperative [[VAS]] of 8, a postoperative score of 3.2, and medium EMS scores of 11.3 preoperatively vs. 14.3 postoperatively. Radiographic analysis showed successful fusion in 74 patients (86%). As shown in previous studies, correction of the C2-C7 angle did not correlate with improvement of neurological symptoms. 

The results show that expandable [[titanium cage]]s are a safe and useful tool in [[anterior cervical corpectomy]] for providing adequate anterior column support and stability
((Pojskic M, Saβ B, Nimsky C, Carl B. Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients. Medicina (Kaunas). 2020 Nov 25;56(12):E642. doi: 10.3390/medicina56120642. PMID: 33255605.)).