PMID- 21681631
OWN - NLM
STAT- MEDLINE
DCOM- 20120924
LR  - 20221207
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Print)
IS  - 0940-6719 (Linking)
VI  - 21
IP  - 1
DP  - 2012 Jan
TI  - Initial experience with the use of an expandable titanium cage as a vertebral 
      body replacement in patients with tumors of the spinal column: a report of 95 
      patients.
PG  - 84-92
LID - 10.1007/s00586-011-1882-7 [doi]
AB  - OBJECTIVE: Vertebral body resection to treat spine tumors necessitates 
      reconstruction to maintain spinal stability. The durability of reconstruction may 
      be a challenge in cancer patients as treatment with chemotherapy and/or radiation 
      coupled with poor nutritional status may compromise bone quality. We present a 
      series of patients who underwent implantation of an expandable titanium cage 
      (ETC) for reconstruction after vertebral body resection for primary or metastatic 
      spine tumors. We report the functional outcome, assess the durability of 
      reconstruction, and describe complications associated with this procedure. 
      METHODS: A retrospective review of patients undergoing placement of ETC after 
      vertebrectomy for spinal tumor at our institution was performed. RESULTS: From 
      September 2001 to August 2006, 95 patients underwent implantation of an ETC for 
      reconstruction of the anterior spinal column following vertebrectomy for tumor 
      (75 one-level, 19 two-level, 1 three-level). All patients underwent spinal 
      stabilization as well. The median survival after surgery was 13.7 months; 23 
      patients had primary spinal tumors and 72 had metastatic tumors. Numerical pain 
      scores were significantly improved postoperatively indicating a palliative 
      benefit. No new neurological deficits were noted postoperatively, except when 
      intentional neurological sacrifice was performed for oncologic reasons. Median 
      height correction of 14% (range 0-118%) and median improvement in sagittal 
      alignment of 6 degrees  (range 0-28 degrees ) were demonstrated on immediate postoperative 
      imaging. Three patients experienced hardware related complications, one of which 
      had posterior migration of the ETC. On postoperative imaging, 12 patients 
      demonstrated subsidence of greater than 1 mm, but none required operative 
      revision. CONCLUSION: Use of an ETC for spinal reconstruction in patients with 
      spinal tumors is safe, decreases pain associated with pathologic fracture, 
      protects neurologic function, and is durable. We found a very low incidence of 
      cage-related construct failures and no significant problems with subsidence.
FAU - Viswanathan, Ashwin
AU  - Viswanathan A
AD  - Department of Neurosurgery, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 
      442, Houston, TX 77030-4009, USA.
FAU - Abd-El-Barr, Muhammad M
AU  - Abd-El-Barr MM
FAU - Doppenberg, Egon
AU  - Doppenberg E
FAU - Suki, Dima
AU  - Suki D
FAU - Gokaslan, Ziya
AU  - Gokaslan Z
FAU - Mendel, Ehud
AU  - Mendel E
FAU - Rao, Ganesh
AU  - Rao G
FAU - Rhines, Laurence D
AU  - Rhines LD
LA  - eng
PT  - Journal Article
DEP - 20110618
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Orthopedic Procedures/instrumentation/*methods
MH  - Prosthesis Implantation/*methods
MH  - Radiography
MH  - Plastic Surgery Procedures/instrumentation/*methods
MH  - Retrospective Studies
MH  - Spinal Neoplasms/diagnostic imaging/pathology/*surgery
MH  - Spine/diagnostic imaging/*pathology/*surgery
MH  - Young Adult
PMC - PMC3252457
EDAT- 2011/06/18 06:00
MHDA- 2012/09/25 06:00
PMCR- 2013/01/01
CRDT- 2011/06/18 06:00
PHST- 2011/01/27 00:00 [received]
PHST- 2011/06/04 00:00 [accepted]
PHST- 2011/05/23 00:00 [revised]
PHST- 2011/06/18 06:00 [entrez]
PHST- 2011/06/18 06:00 [pubmed]
PHST- 2012/09/25 06:00 [medline]
PHST- 2013/01/01 00:00 [pmc-release]
AID - 1882 [pii]
AID - 10.1007/s00586-011-1882-7 [doi]
PST - ppublish
SO  - Eur Spine J. 2012 Jan;21(1):84-92. doi: 10.1007/s00586-011-1882-7. Epub 2011 Jun 
      18.