title: Anterior cervical reconstruction with pedicle screws after a 4-level corpectomy.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To describe a new method of anterior cervical reconstruction with pedicle screws.
  
  
  BACKGROUND
  Anterior reconstruction after multilevel corpectomy is a challenging technique, and there are many reports on its complications. Graft dislodgement is one of the major complications after long cervical fusion. The main cause of failure seems to be a lack of stability in the conventional reconstruction technique. However, pedicle screws for posterior cervical reconstruction show remarkable stability. We describe a new technique of anterior cervical reconstruction with pedicle screws and fibular strut grafting.
  
  
  METHODS
  Seven patients with multilevel cervical myelopathy were treated with this new reconstruction technique after a 4-level corpectomy. We describe this new technique and review the patients' clinical history, results of radiographical imaging, and outcomes. Clinical outcomes were assessed preoperatively and at 3 months postoperatively. Postoperative radiographs were assessed 3 months and 6 months postoperatively.
  
  
  RESULTS
  The mean operative time was 182 minutes and the mean blood loss was 271 mL. The average Japanese Orthopaedic Association score for cervical myelopathy improved from 11.5 points preoperatively to 14.5 points 3 months postoperatively. No patients experienced major complications, such as neurological deterioration, infection, or massive blood loss. There was no case of reconstruction failure, graft dislodgement, migration, or screw displacement.
  
  
  CONCLUSIONS
  To our knowledge, this is the first description of an anterior cervical reconstruction approach, using pedicle screws and fibular strut grafting after a 4-level corpectomy. It is likely that this technique will result in better clinical outcomes with fewer complications in the treatment of patients with multilevel cervical myelopathy.
authors.affiliation: Department of Orthopedic Surgery, Sohma Hospital, Kyoto, Japan. mino-ike5050@lagoon.ocn.ne.jp
authors.forename: Minoru
authors.initials: M
authors.lastname: Ikenaga
authors.forename: Masashi
authors.initials: M
authors.lastname: Mukaida
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Nagahara
authors.forename: Tsunoru
authors.initials: T
authors.lastname: Yasunaga
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ueda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sohma
mesh_terms: D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome