Surgical Reconstruction Using a Flanged Mesh Cage without Plating for Cervical Spondylotic Myelopathy and a Symptomatic Ossified Posterior Longitudinal Ligament

Abstract

Objective :We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL). Methods : Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom's criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months. Results : In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom's criteria or between the single-level and two-level corpectomy groups. Conclusion : The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Comparison of Radiological and Clinical Outcomes between Expandable and Non-expandable Cages Following Cervical Corpectomy: A Systematic Review and Meta-analysis

“…In case of disparities, a concord was drawn up after discussing with an independent third author. Table 2 provides the quality scores of each study, appraising the risk of bias [1][2][3][4][5]7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Nine, 14, and three studies were of good, fair, poor quality, respectively.…”

“…Subsidence was defined as cage intrusion (>2 mm) into the adjacent vertebral endplates, as seen on radiographs. A summary of studies is presented in Table 3 [1][2][3][4][5]7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

Implant Materials for Anterior Column Reconstruction of Cervical Spine Tumor

“…Additionally, Kang et al . 41 proposed a novel method: a flanged TMC, which is also an effective graft for cervical spine anterior column reconstruction.…”

“…Thalgott et al 40 also achieved a 100% fusion rate using TMC combined with a local bone graft in multilevel cervical corpectomy fusion. Additionally, Kang et al 41 proposed a novel method: a flanged TMC, which is also an effective graft for cervical spine anterior column reconstruction.…”