• Spine · Apr 2011

    Risk factors for early reconstruction failure of multilevel cervical corpectomy with dynamic plate fixation.

    • Atsushi Okawa, Kenichiro Sakai, Takashi Hirai, Tsuyoshi Kato, Shoji Tomizawa, Mitsuhiro Enomoto, Shigenori Kawabata, Makoto Takahashi, and Kenichi Shinomiya.
    • Department of Orthopedic and Spinal Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. okawa.orth@tmd.ac.jp
    • Spine. 2011 Apr 20; 36 (9): E582E587E582-7.

    Study DesignRetrospective case series.ObjectiveTo investigate risk factors for early reconstruction failure of multilevel cervical corpectomy with dynamic plate fixation.Summary Of Background DataFor anterior cervical decompression and fusion, reinforcement by plate fixation was performed to decrease early reconstruction failure and to increase the fusion rate. However, a relatively high complication rate such as graft dislodgement, has been reported in patients undergoing multilevel corpectomy and reconstruction. Risk factors associated with early reconstruction failure have not been explicitly described.MethodsIn 30 instrumented multilevel corpectomy and reconstruction, medical records and radiographic studies were reviewed to investigate risk factors with regard to sagittal alignment of the cervical spine, graft subsidence, screws used in fixation, endplate preparation, and intermediate screw for fibular graft.ResultsReconstruction failures included anterior slipping at the bottom of the graft in 2 cases, fracture of the C7 vertebral body in 2 cases, and pullout of a screw in 2 cases. Four patients were found to have nonunion of the graft at the final follow-up, but none had experienced early reconstruction failure.On radiologic measurement, the fusion area lordotic angle after surgery in the patients with reconstruction failures was significantly larger than that of the patients with no complications. The postoperative C2-C7 lordotic angles of the patients with reconstruction failure were also larger, but this trend was not statistically significant. No other factor, such as age and gender, type of screw used, intermediate screw or preservation of the endplates was related to reconstruction failures in this study.ConclusionPostoperative cervical hyperlordosis may adversely affect graft stability in the early postoperative period of the surgery of corpectomy and reconstruction with dynamic plate fixation.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…