Results to 4-year follow-up of the treatment of the cervical stenosis by corpectomy, titanium mesh cage and anterior plate fixation

Background: Cervical spondylotic myelopathy is caused by cervical stenosis. Several techniqueshave been described for the treatment of multilevel disease, such as the anterior corpectomy with titanium mesh cage and anterior cervical plate placement, which has the advantage of performing a wider decompression and using the same bone as graft. However, it has causedcontroversy since the collapse of the mesh cage continues being a major limitation of this procedure. Material and method: A prospective 4-year follow-up study was conducted in 7 patients diagnosed with cervical stenosis, who were treated surgically by one level corpectomy with titaniummesh cage and anterior cervical plate placement, evaluating them by radiographs and clinicalscales. Results: 7 patients, 5 women and 2 males were studied. The most common level was C5 corpectomy (n = 4). The Neck Disability Index (NDI) preoperative average was 30.01 +/- 24.32 and4year postoperative 16.90 +/- 32.05, with p = 0.801. The preoperative and 4-year postoperative Nurick was 3.28 +/- 48 and 3.14 +/- 1.21 respectively, with p = 0.766. Preoperative lordosiswas 14.42 +/- 8.03 and 4-year postoperative 17 +/- 11.67 degrees, with p = 0.660. The immediatepostoperative and 4-year postoperative subsidence was 2.69 +/- 2.8 and 6.11 +/- 1.61 millimetersrespectively, with p = 0.0001. Conclusions: Despite the small sample, the subsidence of the mesh cage is common in thisprocedure. No statistically significant changes were observed in the lordosis or Nurick scale andNDI. (C) 2016 Academia Mexicana de Cirugia A. C. Published by Masson Doyma Mexico S. A.