Study of Vertebral Body Replacement with Reconstruction Spinal Cages in Dorsolumbar Traumatic and Koch's Spine

STUDY DESIGN Retrospective and prospective case series. PURPOSE The aim of this study was to assess the results of reconstruction of anterior column, fusion and complications related to cages. OVERVIEW OF LITERATURE Literature shows that corpectomy has become a common surgical procedure for spinal infection, trauma, deformity, instability and metastasis. Also the use of reconstructive spinal cages is common after corpectomy. METHODS Study was carried out in patients with dorsolumbar traumatic and Koch's spine. We assessed 25 patients (13 traumatic/12 tuberculous) who were treated with cages with/without any other instrumentation. Radiographs were obtained before and after the surgery. A preoperative magnetic resonance imaging was obtained in every patient. RESULTS Fourteen patients underwent 1 level of corpectomy, 9 patients underwent 2 levels and 2 patients underwent 3 levels of corpectomy. Anterior reconstruction alone was performed in 8 patients; 360° reconstruction was performed in 17 patients and 2 of them underwent reconstruction through single posterior approach only. The mean kyphotic angulation improved from 21.2° preoperatively to 9.3° postoperatively and to 12° at final follow up. 8 patients with neurological deficits had improvement by at least one or more Frankel grade. No migration/displacement of cage was seen in any patients. CONCLUSIONS The present study demonstrates that the vertebral body replacement after corpectomy by reconstructive cages provides a reconstruction of the anterior column, good correction of the mean kyphotic angle, and a correction maintained with cage without any cage related complication at long term follow up. The fusion can be achieved with reconstructive cage plus bone graft with or without posterior instrumentation.