Cervical Corpectomy Is Not a Military RankSpinal fusion isn't new, but the materials used for fusion keep changing. Bone graft from the pelvis was once the standard. Problems with pain, fracture, and infection have led doctors to look elsewhere. Donated bone from the bone bank is an option. However, failure of the "borrowed" bone to heal is a problem for some patients. Bone substitute is also being studied.
In this report doctors used another source. They removed bone from the spine to fill mesh cages, which are inserted in place of the bone removed.
The FDA recently approved cages for fusion of the low back. Now doctors are trying the cages in the neck (cervical spine). Forty-five patients at the University of Texas and Southwestern Medical Center had a cervical corpectomy, a procedure to remove the front part of two or more bones in the neck. The surgery is done from the front of the neck.
The removed bone was packed inside mesh cages and the cages put in place of the bone. The leftover bone was placed along each side of the cage. Metal plates and screws were also used along the front of the fusion.
The results? All but one patient had a solid fusion without problems. The one failure had a bone fracture, the metal plate slipped, and the cage moved. A second operation was done later to repair the problems.
The authors present a new way to fuse the neck in cases of degenerative disease. Removing the vertebral body and replacing it with a titanium mesh cage can be done using the patient's own bone. This method may replace the current operation using long solid bone grafts from the patient's own body or from the bone bank.
Zeena Doral, MD, et al. Titanium Cage Reconstruction after Cervical Corpectomy. In Journal of Neurosurgery: Spine. July 2003. Vol. 99. No. 1. Pp. 3-7.
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