Surgical Reconstruction Using a Flanged Mesh Cage without Plating for Cervical Spondylotic Myelopathy and a Symptomatic Ossified Posterior Longitudinal Ligament

J Korean Neurosurg Soc. 2019 Nov;62(6):671-680. doi: 10.3340/jkns.2019.0060. Epub 2019 Aug 9.

Abstract

Objective: We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL).

Methods: Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom's criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months.

Results: In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom's criteria or between the single-level and two-level corpectomy groups.

Conclusion: The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.

Keywords: Cervical vertebrae ∙ Ossification of posterior longitudinal ligament ∙ Spondylosis ∙ Titanium.

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