Multilevel Corpectomy Strut Graft Can Be Stabilized By Appropriate Reconstruction and Plating

Gary L. Lowery, MD, PhD
Vaddanak P. Seng, BS
Samir Kulkarni, MD (Gainesville, FL)

Introduction:

Appropriate anterior plate stabilization of composite strut grafts in reconstruction of multilevel corpectomy defects offers potential advantages over autograft or allograft strut reconstruction.

Methods:

39 consecutive patients underwent multilevel corpectomy reconstruction (2–3 levels) using titanium surgical mesh (TSM) or carbon fiber spacers (CFS) stabilized by Divergent Orion Anterior Cervical Plate between March 1994 and July 1998. 36 patients had at least 6 months follow–up (N=36)(F/U=93%). Average follow–up was 2s mo (range: 6–56 mo). There were 23 females and 13 males. Average age was 52 years (range: 27–74). Corpectomy reconstruction was 2–levels in 24 patients and 3–levels in 12 patients. TSM and CFS were used in 19 and 17 cases respectively, with local autograft within the spacers.

Results:

There were no cases of graft extrusion or broken plates. Four patients demonstrated minimal plate loosening (1–2mm). One patient had mild plate displacement after inferior body fracture. One patient had a loose intervening screw and 4 had broken inferior screws. Radiographs showed solid fusions in 27 patients. 9 patients (25%) had nonunions. 3 required revisions and 4 had salvage posterior surgeries. All secondary surgeries went on to solid fusion. No clear association between number of corpectomy levels and fusion rate was discerned. Al latest follow–up visit prior to any secondary surgeries, 85% of patients with solid fusion felt better than before surgery (23/27) and 67% of those with nonunion felt better (6/9).