Artikel
Cervical corpectomies: Results of a survey on diagnosis, indications and surgical technique
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Autoren
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Sebastian Hartmann
- Klinik für Neurochirurgie, Medizinische Universität Innsbruck
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Anja Tschugg
- Klinik für Neurochirurgie, Medizinische Universität Innsbruck
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Sabrina Neururer
- Klinik für Medizinische Statistik, Informatik und Gesundheitsökonomie, Medizinische Universität Innsbruck
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Jochen Obernauer
- Klinik für Neurochirurgie, Medizinische Universität Innsbruck
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Ondra Petr
- Klinik für Neurochirurgie, Medizinische Universität Innsbruck
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Claudius Thomé
- Klinik für Neurochirurgie, Medizinische Universität Innsbruck
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: Although cervical corpectomies are increasingly used, there is a paucity of evidence-based data on the indications, surgical approaches and complications of these procedures. Thus, a survey on the diagnosis, indications, surgical planning and complications of cervical corpectomies was conducted to elucidate treatment strategies of spine surgeons in central Europe. Special attention was given to the preoperative planning and the decision making for additive dorsal approaches in multilevel cases.
Method: An online survey consisting of eighteen questions on the preoperative, intraoperative and postoperative management of cervical corpectomies was prepared. A total of 1137 contacts of surgeons were provided by the "German Society of Spine Surgeons" (DWG), "German Society of Neurosurgeons" (DGNC), "Austrian Spine Society" (ASS) and the "Austrian Society of Neurosurgeons" (OEGNC).
Results: 302 (27%) surgeons attended the survey and demonstrated the wide variability of treatment options. The majority (51%) perform less than 5 anterior cervical corpectomies and fusion (ACCF) procedures per year followed by 35% performing 5 to 20 cases per year. 41% of the participants prefer ACDF over laminoplasty / laminectomy (19%, 16%, respectively) and ACCF (12%). The most common indication for ACCF is represented by degenerative (27%), traumatic (17%) or neoplastic (20%) diseases. Intra- and postoperative complications were mainly associated with hardware failure. Intra- and postoperative complications were mainly found to be implant-associated. To increase the stability of the construct, 33% of the specialists tend do perform a second additive dorsal approach for either 2- or 3-level corpectomies.
Conclusions: Currently, there is no consensus on the treatment of complex cervical disease and the use of cervical corpectomies in central Europe. Overall, the procedure is still rarely performed and the need for additional dorsal fixation is unclear in the community. Further studies should investigate this patient population to establish standards in patient care.
