Lumbar extracavitary corpectomy with a single stage circumferential arthrodesis: surgical technique and clinical series.
Circumferential arthrodesis and reconstruction is necessary after a lumbar corpectomy in the setting of malignancy and infection. The advent of expandable cage technology now allows for safe anterior column reconstruction via a posterior approach with no transection and minimal retraction of the lumbar spinal nerve roots.     Fifteen patients underwent a single-stage, circumferential corpectomy and anterior spinal reconstruction with an expandable cage via a midline, posterior, lateral lumbar extracavitary approach. Posterior segmental pedicle screw fixation and iliac crest bone graft was used in all cases.     Fifteen lumbar extracavitary corpectomy nerve root-sparing procedures have been performed to date, with at least 1-year follow-up (12 tumors/3 infections). No patient suffered any neurological complications. One patient suffered from a postoperative myocardial infarction 10 days after the procedure. Two patients had medical complications that were treated without sequelae.     We present a technical description and case series of patients undergoing a single-stage, circumferential corpectomy and anterior spinal reconstruction with an expandable cage via a midline, posterior, lateral lumbar extracavitary approach with at least 1-year follow-up. The technique is safe, technically feasible, and obviates an anterior approach in this oftentimes critically ill patient population.
Rush University Medical Center, Chicago, Illinois. kern.singh@rushortho.com.
Kern
K
Singh
Daniel K
DK
Park
D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D001863:Bone Screws; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D019651:Plastic Surgery Procedures; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000601:surgery