Anterior Cervical Corpectomy And Reconstruction With Titanium Mesh And Bone Graft In Cervical Disc Disorders

Objective: To evaluate effect of anterior cervical corpectomyand reconstruction with titanium mesh and bone graft in cervicaldisc disorders, and also to study its surgical techniques. Method:From October 2003 to September 2005, 256 cases with cervicaldegenerative spondylosis were treated in the department, Carefuland thorough preoperative evaluation was conducted. 68 cases ofanterior cervical corpectomy and reconstruction with titaniummesh and bone grafting were selected. There were two levers tomultiple levels in 68 cases. One level partial vertebral removalwith two disc space decompression plus titanium mesh and bonegrafting and plating were carried out in 25 cases, two or morepartial vertebral removal with multiple levels decompression plustitanium mesh bone grafting and plating in 43 cases. The bonemineral density, the integrity of endplate and trimming &placement method of the mesh, were documented. neurologicalfunction was estimated by JOA grade and the change of cervical.To understand the long term follow up results and to discuss thekey-point of anterior cervical decompression and fusionprocedures. Result : All patients underwent the surgery safelyand there were no death or neurological injury occurred. Thefollow-up period was 6-18 months, averaged 8 months.Preoperative JOA scores were 9.1, and the postoperative JOAscores were 14.4 at the final follow-up ,the mean recovery ratewas 67%. Of these 68 patients , 32 patients (47.1%) obtainedexcellent results, 25(36.8%) good, 6(8.8%) fair, 5(7.3%) poor.Postoperative X-ray demonstrated good bone fusion withoutpseudarthrosis . Postoperative MRI showed sufficientdecompression of the spinal cord. In term of technical result,there were great changes in all observed indexes compared withpreoperation and postoperation (P<0.05).Conclusion : Anteriorcervical corpectomy and reconstruction with titanium mesh andbone graft can promote intervertebral body fusion, avoid iliacbone, keep the height of intervertebral space and stability of thefixation segment. Careful and thorough preoperative evalution isessential for surgical treatment of cervical disc disorders.Appropriate surgical procedures should be chosen based on thelevel and severity of deformity. Great care should be takenintraoperatively and postoperatively to ensure the safety of thesurgery and satisfied clinical outcome. For the cervical spineanterior procedures, the key factor for advance of the curativeeffect is adequate decompression, the satisfactory result willdecide by the internal fixator and new material is available.