Single Stage Anterior Cervical Reconstruction with Harms Titanium Mesh Cages, Local Bone Graft and Plating

Introduction:

Autograft has not been used successfully for arthrodesis following corpectomy in the anterior cervical column. Fibular strut allograft has yielded highly variable rates of arthrociesis. We sought an alternative to this method for use in cervical reconstruction.

Materials & Methods:

Twenty–two (22) patients, 12 male and Io female underwent successful, single–stage anterior cervical corpectomy and reconstruction. Average age in this series was 54 years (34–78). Primary diagnoses included: spinal stenosis 15, DDD 2, pseudarthrosis 2, and internal disc disruption 2. All patients were implanted with 1 Harms cage and an AO Cervical Spine Locking Plate. Local Bone graft from the corpectomy was used to fill the cages. There were 21 double–level fusions, and 1 quadruple level–fusion.

Results:

Average follow–up in this series was 36 months with a range of 24 to 59 months. Postoperatively, there was one temporary swallowing problem. One broken screw which caused plate settling occurred in one patient. All other cages, plates, and screws remain fully intact. There was no evidence radiographically of migration or halos indicating a 100% fusion rate. An average pain relief postop vs. preop of 59% was achieved with 64% of patients reporting good or excellent pain relief (due in large part to unrelated co–morbidities).

Conclusion:

We conclude that single stage cervical reconstruction with Harms titanium mesh cages in conjunction with rigid anterior cervical plating is safe and effective and a viable alternative to the use of fibular strut allograft or 360 degree fusion.