Department of Neurosurgery, University of Marburg, 35043 Marburg, Germany.
Marburg Center for Mind, Brain and Behavior (MCMBB), 35032 Marburg, Germany.
Medicina (Kaunas). 2020 Nov 25;56(12):642. doi: 10.3390/medicina56120642.
: Expandable cages are frequently used to reconstruct the anterior spinal column after a corpectomy. In this retrospective study, we evaluated the perioperative advantages and disadvantages 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 titanium cage for a variety of indications 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 Scale) and gait disturbances with the Nurick score. Radiographic analysis comprised measurement of fusion, subsidence and the C2-C7 angle. : Indications included spinal canal stenosis with myelopathy (46 or 53.5%), metastasis (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 ( < 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. : Our results show that expandable titanium cages are a safe and useful tool in anterior cervical corpectomies for providing adequate anterior column support and stability.
: 可扩张 cage 常用于颈椎椎体次全切除术后重建前脊柱柱。在这项回顾性研究中，我们评估了可扩张 cage 在颈椎椎体次全切除术中重建的围手术期优缺点。2012 年 1 月至 2019 年 12 月，我们对 86 例（45 例男性和 41 例女性患者，平均年龄 61.3 岁）因多种原因接受可扩张钛 cage 治疗的患者进行了回顾性分析。平均随访 30.7 个月。通过临床检查和视觉模拟量表（VAS）评估结果；根据欧洲脊髓病量表（EMS）和步态障碍的 Nurick 评分对脊髓病进行分类。影像学分析包括融合、下沉和 C2-C7 角的测量。: 适应证包括脊髓型颈椎病伴脊髓病（46 例，占 53.5%）、转移瘤（24 例，占 27.9%）、脊椎炎（12 例，占 14%）和骨折（4 例，占 4.6%）。在 39 例患者（45.3%）中，进行了额外的后路稳定（360°融合）。13 例患者发生内固定失败，8 例患者发生相邻节段疾病。术后疼痛症状、脊髓病和步态改善均有统计学意义（<0.05），术前 VAS 中位数为 8，术后评分 3.2，术前 EMS 评分中位数为 11.3，术后为 14.3。影像学分析显示 74 例患者（86%）融合成功。与以往研究一致，C2-C7 角的矫正与神经症状的改善无关。: 我们的结果表明，可扩张钛 cage 在前路颈椎椎体次全切除术中是一种安全有效的工具，可提供充分的前柱支撑和稳定性。
