Clinical and radiological outcomes of one-level cervical corpectomy with an expandable cage for three-column uncomplicated subaxial type B injures: a multicenter retrospective study

To evaluate the clinical and radiological results of the operative management of three-column uncomplicated type B subaxial injures treated with a one-level cervical corpectomy with an expandable cage. Methods This study included 72 patients with a three-column uncomplicated type B subaxial injures who met the inclusion criteria, underwent a one-level cervical corpectomy with an expandable cage at one of three neurosurgical departments between 2005 and 2020, and were followed up for clinical and radiological outcomes at a minimum 3-yr follow-up. Results There was a decrease in the VAS pain score from an average of 80 mm to 7 mm (p = 0.03); a decrease in the average NDI score from 62 to 14% (p = 0.01); excellent and good outcomes according to Macnab's scale were 93% (n = 67/72). There was an average change in the cervical lordosis (Cobb method) from -9.10 to -15.40 (p = 0.007), without significant loss of lordosis (p = 0.27). There was no significant degeneration of the adjacent levels by 3 years post-op. The fusion rate, using the Cervical Spine Research Society criteria, was poor: it was 62.5% (n = 45/72), and using the CT criteria, it was 65.3% (n = 47/72). 15.4% patients (n = 11/72) suffered complications. Statistical difference between the fusion and pseudoarthrosis (according to X-ray criteria) subgroups showed that there were no statistically significant differences in the smoking status, diabetes, chronic steroid use, cervical injury level, subtypes of AO type B subaxial injuries and types of expandable cage systems. Conclusions One-level cervical corpectomy with an expandable cage, despite a poor fusion rate, can be considered a feasible and relatively safe method for treating three-column uncomplicated subaxial type B injures, with the benefit of immediate stability, anatomical reduction, and direct decompression of the spinal cord. While no one in our series had any catastrophic complications, we did note a high complication rate.

Automated summary

The study evaluated the clinical and radiological outcomes of treating three-column uncomplicated type B subaxial injuries with one-level cervical corpectomy and an expandable cage. The results showed improvement in pain scores, NDI scores, and excellent/good outcomes according to Macnab's scale. However, the fusion rate was low, and complications were relatively high. The study concluded that while the procedure offers immediate stability and decompression, it has limitations in terms of fusion and complications.