Complications of buttress plate stabilization of cervical corpectomy.
METHODS
A retrospective analysis of 14 patients treated with cervical corpectomy and buttress plate fixation.


OBJECTIVE
To determine the complications of buttress plate fixation following multilevel cervical corpectomies.


BACKGROUND
Buttress plate fixation of multilevel cervical corpectomy has recently been reported. Biomechanical data suggests that it is preferable to long plates spanning the entire corpectomy site. There are no clinical studies that have specifically addressed the complications of this type of plate fixation.


METHODS
The records and radiographs of all patients who had undergone cervical buttress plate fixation following anterior cervical corpectomy for myelopathy were independently reviewed. Twelve of the patients had three-level corpectomies and two had two-level corpectomies. All patients had placement of a short plate at the inferior end of the construct with sufficient overhang to act as a buttress against graft extrusion. Three patients underwent posterior cervical fusion in addition to the anterior procedure.


RESULTS
Graft extrusion. One patient had complete graft extrusion on the third post-operative night. A second patient who had undergone circumferential fusion had minimal plate dislodgement secondary to graft settling. Pseudarthrosis. Three patients had pseudarthroses. Two of these required revision posterior surgery. Neurologic. None of the patients suffered neurologic complications. With the exception of the one patient who died, the rest of the patients all improved by at least one Nurick grade.


CONCLUSIONS
The most catastrophic complication in the present series was plate dislodgement causing airway compromise and eventually resulting in death. Surgeons who utilize these types of buttress plates without additional posterior instrumentation should be aware of the potential complications of buttress plate fixation.
Riew
K D
KD
Department of Orthopaedic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.
Sethi
N S
NS
Devney
J
J
Goette
K
K
Choi
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects*; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D013128:Spinal Osteophytosis / Q000601:surgery*