Preventing Construct Subsidence Following Cervical Corpectomy: The Bump-stop Technique

Abstract

Cervical corpectomy is a viable technique for the treatment of multilevel cervical spine pathology. Despite multiple advances in both surgical technique and implant technology, the rate of construct subsidence can range from 6% for single-level procedures to 71% for multilevel procedures. In this technical note, we describe a novel technique, the bump-stop technique, for cervical corpectomy. The technique positions the superior and inferior screw holes such that the vertebral bodies bisect them. This allows for fixation in the dense cortical bone of the endplate while providing a buttress to corpectomy cage subsidence. We then discuss a retrospective case review of 24 consecutive patients, who were treated using this approach, demonstrating a lower than previously reported cage subsidence rate.

Anterior 1-2 Level Cervical Corpectomy and Fusion for Degenerative Cervical Disease: A Retrospective Study With Lordotic Porous Tantalum Cages. Long-Term Changes in Sagittal Alignment and Their Clinical and Radiological Implications After Cage Subsidence

“…Placement of an anterior plate provides additional stability, increases the rate of bone fusion, and prevents implant dislocation and late kyphotic deformities. 4,19,23,24 Furthermore, precontouring of the anterior cervical plate aids in restoring cervical lordosis. The authors use a semiconstrained screw-plate interface to supplement final arthrodesis stability.…”

Management of patients with cervical myelopathy

“…To fill the defect a titanium interbody cage and a bone graft are used. Then the anterior plate is used to secure the construct [20]. Possible complications include: C5 nerve root palsy, spinal cord injury, dysphagia (2-48%), hoarseness (temporary 3-11%), pseudarthrosis, perforation of the oesophagus, graft complication, carotid or vertebral artery injury (0.03%), dural tear with cerebrospinal fluid leakage, transient Horner syndrome, and degeneration of adjacent segments (3%) [4,19].…”

Dynamics of pain intensity in patients after anterior subaxial cervical fusion

“…Розвиток вертебрології в останні десятиліття характеризується активним впровадженням у клінічну практику широкого спектру імплантатів стабілізувального або одночасно тілозамінного та стабілізувального призначення [3][4][5]. Велика кількість наукових робіт присвячена перевагам тих чи тих матеріалів, з яких виготовлено імплантати, конструктивними особливостями пристроїв, зручності установки конструкції під час оперативного втручання, динаміці рентгенологічної картини в післяопераційний період тощо [6][7][8][9][10].…”