title: Posterior approach for thoracolumbar corpectomies with expandable cage placement and circumferential arthrodesis: a multicenter case series of 67 patients.
abstract: OBJECTIVE
  The purpose of this multicenter trial was to investigate the outcome and durability of a single-stage thoracolumbar corpectomy using expandable cages via a posterior approach.
  
  
  METHODS
  The authors conducted a retrospective chart review of 67 consecutive patients who underwent single-stage thoracolumbar corpectomies with circumferential reconstruction for pathological, traumatic, and osteomyelitic pathologies. Circumferential reconstruction was accomplished using expandable cages along with posterior instrumentation and fusion. Correction of the sagittal deformity, the American Spinal Injury Association score, and complications were recorded.
  
  
  RESULTS
  Single-stage thoracolumbar corpectomies resulted in an average sagittal deformity correction of 6.2° at a mean follow-period of 20.5 months. At the last follow-up, a fusion rate of 68% was observed for traumatic and osteomyelitic fractures. Approximately one-half of the patients remained neurologically stable. Improvement in neurological function occurred in 23 patients (38%), whereas 7 patients (11%) suffered from a decrease in lower-extremity motor function. The deterioration in neurological function was due to progression of metastatic disease in 5 patients. Five constructs (7%) failed-3 of which had been placed for traumatic fractures, 1 for a pathological fracture, and 1 for an osteomyelitic fracture. Other complications included epidural hematomas in 3 patients and pleural effusions in 2.
  
  
  CONCLUSIONS
  Single-stage posterior corpectomy and circumferential reconstruction were performed at multiple centers with a consistent outcome over a wide range of pathologies. Correction of the sagittal deformity was sustained, and the neurological outcome was good in the majority of patients; however, 18% of acute traumatic fractures required revision of the construct.
authors.affiliation: Weill Cornell Brain and Spine Center, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York 10021, USA.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Hofstetter
authors.forename: Dean
authors.initials: D
authors.lastname: Chou
authors.forename: C Benjamin
authors.initials: CB
authors.lastname: Newman
authors.forename: Henry E
authors.initials: HE
authors.lastname: Aryan
authors.forename: Federico P
authors.initials: FP
authors.lastname: Girardi
authors.forename: Roger
authors.initials: R
authors.lastname: Härtl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult