Failure and Complication Rates of Anterior Instrumentation in Patients Undergoing Cervical Corpectomy Decompression

Vinay Deshmukh, MD
Matthew Wills, MD (Lubbock, TX)
Howard Morgan, MD (Dallas, TX)

This study assesses the rate of anterior cervical instrumentation failure and complication in patients who underwent cervical corpectomy and strut graft reconstruction. Several recent publications have suggested a relatively high failure rate during the first 3 monghts following surgery for long segment anterior cervical corpectomy/corepectomies by the senior author (HM) from 1994 through 1998 at Zale Lipshy University Hospital with anterior plating and strut graft reconstruction; 67 of these were for decompression of non–traumatic cervical stenosis, spondylosis and/or disc herniation; one case followed excision of an anterior intramedullary tumor. Thirty–five were one level, 29 were two level and four were three level corpectomies. The average follow–up was approximately one year. Fusion was confirmed, usually at 6 months, with flexion/extension lateral x–rays and/or CT scanning. Instrumentation failure was defined as non–fusion or symptomatic plate and/or screw backout or breakage. An instrumentation complication was defined as non–symptomatic plate and/or screw backout significant enough to warrant removal. Early failure (< 3 months following surgery) was seen in one case, a one level corpectomy. Two patients had late failure (> 3 months post–op); both had undergone a two level corpectomy. Five patients had instrument complications and had hardware removal, three two level and two one level corpectomies. This study suggests excellent durability of multilevel anterior cervical instrumentation for reconstruction in patients undergoing cervical corpectomy with infrequent instrumentation complication necessitating removal.