1485. Application of an Expandable Cervical Cage in a Retrospective Consecutive Series of 61 Patients

Authors: Mirza Pojskic, MD; Miriam Bopp, MD, PhD; Christopher Nimsky, MD, PhD; Barbara Carl, MD, PhD (Marburg, Germany)

Introduction: 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 cervical corpectomy with a distractable Cage in a short time follow-up. Methods: 61 patients (31 male and 30 male patients, medium age 60.9 years) that are treated withexpandable titanium Cages for a variety of indications between January 2012 and December 2016 were analyzed retrospectively. The mean follow up was 14 months. Outcome was measured by clinical examination and Visual Analogue Scale (VAS); myelopathy was classified according to EMS (European Myelopathy Scale). Radiographic Analysis comprised measurment of subsidence and Fusion. Results: Indications for corpectomy and reconstruction with an expandable cervical Cage included cervical spinal canal Stenosis with myelopathy (n=38 or 62.3%), spondylodiscitis (n= 6 or 9.8%), metastatic Cancer (n=10 or 16.4%) , traumatic fracture (n=2 or 3.3%) and one Patient with aneurysmatic bone cyst and plasmocytoma. Paresis of biceps muscle and spinal ataxia were the most common deficits. 36 patients (59%) were operated only with a ventral Approach, 16 of These had only a standalone Cage, in 25 or 41% additional dorsal stabilization (360 Grade Fusion) was performed. In ten patients (16.4%) Revision operations were performed due to Hardware failure with dislocation of the Cage, two of These patients received additional dorsal surgery for stabilization and eight were reoperated ventral. Improvement of pain Symptoms, myelopathy and gait after surgery were statistically significant (p<0.05), with medium preoperative VAS 5.35 and postoperative score of 2.5, medium EMS Score preoperative: 13.45 vs. postoperative: 15.55. Radiographic Analysis showed successfull in 80.3% of cases, subsidence was evident in eight patients (13.1%). Conclusion: 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.