Total En Bloc Spondylectomy of C7 Vertebrae for Primary Bone Tumors: The Efficacy of Autologous Sternal Structural Grafts

Abstract

Aim: To evaluate the efficacy and safety of total en bloc spondylectomy with autologous sternal structural graft, subaxial pedicle screws, and 5.5 mm titanium rods in primary bone tumor surgery.

Material and methods: From January 2019 to February 2020, two patients with lower cervical spine (C7) primary bone tumor underwent total en bloc spondylectomy, interbody fusion with sternal structural autograft, and posterior instrumentation using subaxial pedicle screws. The medical records and radiographic findings of the patients were reviewed.

Results: C7 total en bloc spondylectomy was successfully performed; the anterior column was reconstructed with an autologous sternal structural graft with posterior instrumentation using subaxial pedicle screws and 5.5 mm titanium rods. After surgery, the VAS scores of neck and radiating arm pain in both patients were relieved considerably. Bony fusion was achieved in all patient by 6 months after surgery. There were no postoperative complications associated with the donor site.

Conclusion: Structural bone obtained from the sternum is safe and provides a viable alternative to cervical fusion for patients with primary bone tumor. It confers the advantages of autograft fusion without the complications associated with donor site morbidities.