X-ray evaluation of the efficiency of vertebral body replacement systems for anterior subaxial cervical fusion

E.I. Slynko, A.S. Nekhlopochin


Background. Anterior cervical fusion is the most common method of surgical correction for majority of subaxial spine traumatic injuries. Despite the wide range of vertebral body replacement systems, in the modern literature, there is no data on the advantages of using a certain type of implant for various damages to the osteoligamentous apparatus. The purpose of the study was to evaluate the radiographic effectiveness of vertebral body replacement systems for anterior fusion in various traumatic injuries of the cervical spine. Materials and methods. We have performed the analysis of X-ray data of 70 patients, who underwent anterior subaxial fusion surgery due to traumatic injury of the cervical spine. We have analyzed the efficiency of restoring segmental kyphosis of the operated segment and the stability of the achieved correction in the postoperative period. The follow-up period was: intraoperatively, 3–5 days, 3, 6 and 12–18 months after the surgery. As a stabilization system, we used combination “mesh + ventral plate” and telescopic vertebral body replacement implant. Fractures are classified according to the main classes of AOSpine subaxial cervical spine injury classification system. Results. Intraoperative radiographs indicate a more dosed correction of the segmental kyphosis of the operated segment when using telescopic implant. So, 87.5 % of the analyzed cases are in the required range of values. This index was 50 %, when the combination of mesh and ventral plate was used. The analysis of the dynamics of correction failure indicates a greater stability of the achieved fusion when using vertebral body replacement implant. On day 3–5 of the postoperative period, the maximum increase in segmental kyphosis is recorded with C type of injury and with the use of the combination of mesh and ventral plate. Minimal deformation was noted when using telescopic implant and in type A injury. A similar dependence is observed during all further observation periods. Conclusions. When performing anterior subaxial cervical fusion, type A injuries are the most stable, and maximum risk of the achieved intraoperative correction failure is detected with type C injuries. The use of telescopic vertebral body replacement implant provides greater safety of the sagittal contour of the operated segment at all periods of observation as compared to the combination of mesh and ventral plate.


anterior spinal fusion; cervical spine; traumatic injury; stabilization system


Барыш А.Е. Передний межтеловой цервикоспондилодез с применением вертикальных цилиндрических сетчатых имплантатов [Текст] / А.Е. Барыш, Р.И. Брузницкий // Ортопедия, травматология и протезирование. — 2010. — № 4. — С. 50-55.

Нехлопочин А.С. Телозамещающий телескопический эндопротез для субаксиального цервикоспондилодеза [Текст] / А.С. Нехлопочин, А.И. Швец, С.Н. Нехлопочин // Вопросы нейрохирургии. — 2016. — Т. 80. — № 1. —

С. 19-26. DOI: 10.17116/neiro201680119-26.

Хирургическая техника вентральной декомпрессии спинного мозга с корпородезом телескопическими устройствами [Текст] / Е.И. Слынько, В.В. Вербов, В.В. Соколов и др. // Український нейрохірургічний журнал. — 2005. — № 4. — С. 63-71.

A case of cervical tuberculosis with severe kyphosis treated with a winged expandable cage after double corpectomy [Text] / L. Nigro, R. Tarantino, P. Donnarumma et al. // J. Spine Surg. — 2017. — Vol. 3. — № 2. — P. 304-308. DOI: 10.21037/jss.2017.06.02.

A systematic review of the use of expandable cages in the cervical spine [Text] / B.D. Elder, S.-F. Lo, T.A. Kosztowski et al. // Neurosurg. Rev. — 2016. — Vol. 39. — № 1. — P. 1-11. DOI: 10.1007/s10143-015-0649-8.

Anterior multiple cervical corpectomy and fusion [Text] / R. Bassani, C. Lamartina, G. Casero, P. Berjano // Eur. Spine J. — 2014. — Vol. 23. — № 9. — P. 2024-2025. DOI: 10.1007/s00586-014-3497-2.

Anterior Surgery for Unstable Lower Cervical Spine Injuries [Text] / E. Lambiris, P. Zouboulis, M. Tyllianakis, E. Panagiotopoulos // Clin. Orthop. Relat. Res. — 2003. — Vol. 411, № 411. — P. 61-69. DOI: 10.1097/

Anterior Surgical Fixation for Cervical Spine Flexion-Distraction Injuries [Text] / A. Jack, G. Hardy-St-Pierre, M. Wilson et al. // World Neurosurg. — 2017. Vol. 101. — P. 365-371. DOI: 10.1016/j.wneu.2017.02.027.

AOSpine subaxial cervical spine injury classification system [Text] / A.R. Vaccaro, J.D. Koerner, K.E. Radcliff et al. // Eur. Spine J. — 2016. — Vol. 25. — № 7. — P. 2173-2184. DOI: 10.1007/s00586-015-3831-3.

Application of AOSpine Subaxial Cervical Spine Injury Classification in Simple and Complex Cases [Text] / B. Aarabi, C. Oner, A.R. Vaccaro et al. // J. Orthop. Trauma. — 2017. — Vol. 31. — № 9 (Supl.). — P. 24-32. DOI: 10.1097/BOT.0000000000000944.

Artificial cervical vertebra and intervertebral complex replacement through the anterior approach in animal model: a biomechanical and in vivo evaluation of a successful goat model [Text] / J. Qin, X. He, D. Wang et al. // PLoS One. — 2012. — Vol. 7. — № 12. — P. 1-13. DOI: 10.1371/journal.pone.0052910.

Assessing the amount of distraction needed for expandable anterior column cages in the cervical spine [Text] / M. Sewell, L. Rothera, O. Stokes et al. // Ann. R. Coll. Surg. Engl. — 2017. — Vol. 99. — № 8. — P. 659-660. DOI: 10.1308/rcsann.2017.0052.

Cages with fixation wings versus cages plus plating for cervical reconstruction after corpectomy — is there any difference? [Text] / M. Cabraja, A. Abbushi, S. Kroppenstedt, C. Woiciechowsky // Cent. Eur. Neurosurg. — 2010. — Vol. 71. — № 2. — P. 59-63. DOI: 10.1055/s-0029-1

Complications associated with cervical vertebral body replacement with expandable titanium cages [Text] / C. Brenke, S. Fischer, A. Carolus et al. // J. Clin. Neurosci. — 2016. — Vol. 32. — P. 35-40. DOI: 10.1016/j.jocn.2015.12.036.

Einfluss von Design und Implantationstechnik auf das Risiko der progredienten Sinterung verschiedener HWS-Cages [Text] / S. Fürderer, F. Schöllhuber, J.-D. Rompe, P. Eysel // Orthopade. — 2014. — Vol. 31. — № 5. — P. 466-471. DOI: 10.1007/s00132-001-0289-2.

Internal fixation of cervical trauma following corpectomy and reconstruction. The effects of posterior element injury. [Text] / J.M. Spivak, S. Bharam, D. Chen, F.J. Kummer // Bull. Hosp. Jt. Dis. — 2000. — Vol. 59. — № 1. — P. 47-51.

Kanna, R.M. Modified anterior-only reduction and fixation for traumatic cervical facet dislocation (AO type C injuries) [Text] / R.M. Kanna, A.P. Shetty, S. Rajasekaran // Eur. Spine J. — 2017. — P. 1-7. DOI: 10.1007/s00586-017-5430-y. [Epub ahead of print]

Nekhlopochin A.S. The analysis of stress-strain state in the cortical screw-vertebral body system when modelling of fixation of implants for anterior cervical interbody fusion [Text] / A.S. Nekhlopochin, S.N. Nekhlopochin, G.V. Syrovoy // Russ. J. Biomech. — 2017. — Vol. 21. — № 1. — P. 77-88. DOI: 10.15593/RZhBiomeh/2017.1.08.

Prognostic Value of Lordosis Decrease in Radiographic Adjacent Segment Pathology After Anterior Cervical Corpectomy and Fusion [Electronic Resource] / Y. Liu, N. Li, W. Wei et al. // Sci. Rep. — 2017. — Vol. 7. — № 1. — P. 14414. DOI: 10.1038/s41598-017-14300-4. URL:

Spine Trauma — What Are the Current Controversies? [Text] / C. Oner, S. Rajasekaran, J.R. Chapman et al. // J. Orthop. Trauma. — 2017. — Vol. 31. — № 9 (Supl.). — P. 1-6. DOI: 10.1097/BOT.0000000000000950.

Zaveri G. Management of Sub-axial Cervical Spine Injuries [Text] / G. Zaveri, G. Das // Indian J. Orthop. — 2017. — Vol. 51. — № 6. — P. 633-652. DOI: 10.4103/ortho.IJOrtho_192_16.

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