Anterior cervical plating for the treatment of neoplasms in the cervical vertebrae

Object. To assess clinical outcome and survival in patients with cervical v ertebral spinal neoplasms after they have undergone anterior decompression and cervical plate stabilization (ACPS) by using either autologous bone gra ft or polymethylmethacrylate (PMMA) as the anterior load-bearing support st ructure. Methods. This was a retrospective case study composed of 30 patients harbor ing cervical spinal vertebral neoplasms who underwent anterior cervical dec ompression and (ACPS) within a 7-year period. Postoperative immobilization included treatment in a halo brace in two cases and in a hard cervical coll ar for the remaining patients. Postoperatively most patients underwent radi o- and/or chemotherapy. All patients except one benefited from a significan tly improved quality of life with decreased pain and/or improved neurologic al status. The mean Kaplan-Meier survivoral estimate was 35.8 months (range 8 days-11.3 years, with 10 patients alive at most recent follow-up contact ). Patients achieved long-term or lifelong mechanical stability in the cerv ical spine, and only one patient required a repeated posterior stabilizatio n procedure. No hardware-related complications occurred. One patient died 8 days postoperatively of pneumonia . A nonsignificant difference in surviva l (p = 0.2164) was observed between patients harboring metastatic neoplasms (26.8 months) and those harboring lymphomatous and multiple myeloma neopla sms (54 months). Conclusions. Favorable clinical outcome of both neurological symptoms and p ain can be achieved using ACPS after surgery for neoplasms in the cervical vertebrae. Furthermore, long-term or lifelong cervical spine mechanical sta bility ty with bone fusion is achieved using this technique even when radia tion therapy is delivered to the site of the bone graft.