Abstract
Objective: Cervical spondylotic myelopathy is a progressive debilitating disease that favorably responds to surgical decompression. The objective of this study was to review the use of expandable titanium cages for reconstruction of the spine after cervical corpectomy. Methods: We searched PubMed and Google Scholar databases up to March 2013 to identify English articles reporting the use of expandable titanium cages in cervical spondylotic myelopathy (CSM). Identified articles were excluded if they lacked CSM cases, radiologic or clinical outcomes were not reported, and if only static cages cases were reported. Additional relevant references from these articles were also reviewed. Results: A total of six case series published from 2005 through 2012 with a combined total of 143 patients who underwent implantation of an expandable titanium cage and a mean follow-up of 21.4 months were identified and included for review. The combined fusion rate was 97%, and the mean correction of cervical lordosis reported for 125 patients was 10.1°. The combined complication rate was 10%, and the overall reported outcomes were favorable. Conclusions: The results of this review demonstrate that the use of expandable titanium cages is safe and effective after decompression in the treatment of cervical spondylotic myelopathy. The features of the expandable titanium cages allow for easier incorporation of the cage into a corpectomy defect relative to a static titanium mesh cage, adding structural support and restoring sagittal alignment.
Highlights
BackgroundCervical spondylotic myelopathy (CSM) is a progressive degenerative process of the cervical spine resulting in narrowing of the spinal canal, causing a variety of nonspecific clinical symptoms that make early diagnosis challenging
The results of this review demonstrate that the use of expandable titanium cages is safe and effective after decompression in the treatment of cervical spondylotic myelopathy
The features of the expandable titanium cages allow for easier incorporation of the cage into a corpectomy defect relative to a static titanium mesh cage, adding structural support and restoring sagittal alignment
Summary
Cervical spondylotic myelopathy (CSM) is a progressive degenerative process of the cervical spine resulting in narrowing of the spinal canal, causing a variety of nonspecific clinical symptoms that make early diagnosis challenging. The overall prevalence of CSM is unknown, but CSM is the most common cause of myelopathy in adults over 55 years of age and causes progressive disability [1,2]. A high degree of clinical suspicion is needed to make an early diagnosis, and unlike other pathologies of the spine, multiple studies have shown progressive neurologic deterioration in up to two-thirds of patients with CSM treated with medical management alone [2]. In CSM patients following multilevel decompression with bone grafting, the rate of solid osseous union is higher in non-smokers than smokers [8]
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