title: Complications associated with cervical vertebral body replacement with expandable titanium cages.
abstract: Our aim was to analyze complications and risk factors for cervical vertebral body replacement (VBR) with expandable titanium cages (ETC). Fifty patients; 22 women and 28 men, mean age 61years, undergoing cervical VBR from 2010 to 2015 were analyzed. Complications were stratified by hardware-association (HA). Univariate and multivariate logistic regression was used to identify independent risk factors. Single, two and three level corpectomies were performed in 32, 15 and 3 patients respectively. A circumferential approach was necessary in 16 cases. At mean follow-up (7.3 months) 66% of patients had recovered. Radiological data showed a significant distraction (2.60mm, p<0.0001) and lordosis (5°, p=0.001). Twenty-three patients experienced 42 complications; 18 HA, 24 non-HA and 24% needed revision surgery. The number of corpectomy levels and surgical approach significantly correlated with the risk of complications (p=0.001), especially non-HA complications (p=0.002). On multivariate analysis, only the number of corpectomy levels (p<0.02, odds ratio 5.48, 95% CI 1.31-22.91) was a significant predictor of complications. We conclude that ETC are efficacious devices for cervical spine VBR, however, when used for more than 1 level, the corpectomy complication rate significantly increases.
authors.affiliation: Department of Neurosurgery, University Medical Center Langendreer, Ruhr-University-Bochum, In der Schornau 23-25, D-44892 Bochum, Germany. Electronic address: christopher.brenke@kk-bochum.de.
authors.forename: Christopher
authors.initials: C
authors.lastname: Brenke
authors.affiliation: Department of Radiology and Neuroradiology, University Medical Center Langendreer, Ruhr-University-Bochum, D-44892 Bochum, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Department of Neurosurgery, University Medical Center Langendreer, Ruhr-University-Bochum, In der Schornau 23-25, D-44892 Bochum, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Carolus
authors.affiliation: Department of Neurosurgery, University Medical Center Langendreer, Ruhr-University-Bochum, In der Schornau 23-25, D-44892 Bochum, Germany.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Schmieder
authors.affiliation: Department of Neurosurgery, University Medical Center Langendreer, Ruhr-University-Bochum, In der Schornau 23-25, D-44892 Bochum, Germany.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Ening
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D008141:Lordosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013123:Spinal Fusion / Q000009:adverse effects*; D014025:Titanium
chemical_list: D014025:Titanium
keywords: Corpectomy; Expandable titanium cage; Hardware-associated complications; Vertebral body replacement