alexa Management of strut graft failure in anterior cervical spine surgery


Journal of Spine


Abstract Share this page

Although successfully used, long strut grafts are vulnerable to dislodgment, displacement, fracture, and nonunion, which can require revision surgery; thus, meticulous preparation of the vertebral endplate along with exact sizing and harvesting of the bone graft with plating are essential for successful outcomes. Biomechanical data and previous clinical studies support the addition of posterior fusion and fixation following multilevel (more than two-level) corpectomy. The additional posterior instrumentation moves the instantaneous axis of rotation posteriorly, thus approximating its normal location in the posterior vertebral body (VB). Biomechanically, this protects the graft from excessive loads while in extension and explains the clinical success of circumferential instrumentation for long-segment corpectomy reconstructions. If strut fracture occurs with minimal displacement and the graft position is still satisfactory, application of a halo vest and judicious observation are recommended. Significant displacement, kyphosis, or loss of contact of the graft and VB require revision surgery. In patients requiring revision surgery for nonunion, placement of fibular autograft or allograft with use of bone morphogenetic protein is likely to be beneficial. If questions remain regarding bone quality or construct stability, the supplemental use of posterior stabilization is recommended. Various surgical approaches have been advocated for treatment of symptomatic anterior cervical pseudarthroses or nonunion. It remains controversial as to whether the anterior or posterior approach is best. Adequate understanding of the graft and implant biomechanics are essential for a successful outcome.

  • To read the full article Visit
  • Open Access
This article was published in Neurosurg Focus and referenced in Journal of Spine

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • 18th Global Neurologists Annual Meeting on Neurology and Neurosurgery
    Nov 13-15, 2017, Athens, Greece
  • 2nd International Conference on Pediatric Neurology  
    August 31-September 01, 2017 Prague, Czech Republic
  • 12th Global Neurologists Annual Meeting on Neurology and Neurosurgery
    November 16-18, 2017 Lisbon, Portugal

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version