Vertebral Body Reconstruction using Expandable Titanium Cages after Anterior Decompression for Cervical Spondylotic Myelopathy: A Review

Objective: Cervical spondylotic myelopathy is a progressive debilitating disease that favorably responds to surgical decompression. The objective of this study was to review the use of expandable titanium cages for reconstruction of the spine after cervical corpectomy. Methods: We searched PubMed and Google Scholar databases up to March 2013 to identify English articles reporting the use of expandable titanium cages in cervical spondylotic myelopathy (CSM). Identified articles were excluded if they lacked CSM cases, radiologic or clinical outcomes were not reported, and if only static cages cases were reported. Additional relevant references from these articles were also reviewed. Results: A total of six case series published from 2005 through 2012 with a combined total of 143 patients who underwent implantation of an expandable titanium cage and a mean followup of 21.4 months were identified and included for review. The combined fusion rate was 97%, and the mean correction of cervical lordosis reported for 125 patients was 10.1°. The combined complication rate was 10%, and the overall reported outcomes were favorable. Conclusions: The results of this review demonstrate that the use of expandable titanium cages is safe and effective after decompression in the treatment of cervical spondylotic myelopathy. The features of the expandable titanium cages allow for easier incorporation of the cage into a corpectomy defect relative to a static titanium mesh cage, adding structural support and restoring sagittal alignment. Categories: General Surgery, Neurosurgery