Abstract

Introduction: Expandable cages have been utilized as an option for immediate spinal stabilization after vertebrectomy. However, long-term follow-up in the oncology population has not been studied, and results remain unclear. This single-institution series of patients represents our success in utilizing expandable cages. Methods: A retrospective chart review for patients with spinal metastasis treated with expandable cages between 2001 and 2006 was performed with IRB approval. Data regarding date of anterior and posterior surgery, immediate postoperative neurological status versus preoperative status, revision, equipment status, pseudoarthrosis, time to ambulation, and mortality were gathered and analyzed. Results: Twenty-four patients with metastatic cancer to the spine were studied. Cages were placed from T5-L5, 21 of which were single level. Of the 24 patients, 5 (21%) were neurologically intact pre-operatively and postoperatively. 13 of the 24 (54%) improved postoperatively. The remaining six (25%) illustrated no change in neurologic status. No patients deteriorated. At two years’ follow-up, overall patient survival was 79%. Average time to ambulation for patients followed was 11.5 days. No revisions were done for hardware failure, while one revision was performed for tumor progression. Conclusions: Expandable cages appear to be a valid treatment option for the immediate stabilization of the spine following corpectomy from spinal metastasis. Results indicate that fast recovery, reasonable long-term mortality, and immediate stabilization are achievable with this modality. Consequently, expandable cages should be considered as a valid option in the treatment for stabilization following corpectomy in metastasis to the spine.

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