Background: Despite the known demographic shift with expected doubled rate of vertebral body fractures by the year 2050, a standardized treatment concept for traumatic and osteoporotic incomplete burst fracture of the truncal spine does not exist. This study aims to determine whether minimally invasive fracture care for incomplete osteoporotic thoracolumbar burst fractures using intravertebral expandable titanium mesh cages is a suitable procedure and may provide improved safety in terms of cement-associated complications in comparison to kyphoplasty procedure.
Methods: In 2011/2012, 15 patients (10 women, 5 men; mean age 77) with 15 incomplete osteoporotic thoracolumbar burst fractures (T10 to L4) were stabilized using intravertebral expandable titanium mesh cages (OsseoFix®) as part of a prospective study. X-ray, MRI and bone density measurements (DXA) were performed preinterventionally. The clinical and radiological results were evaluated preoperatively, postoperatively and after 12 months according to the visual analogue scale (VAS), the Oswestry Disability Index (ODI), X-ray (Beck Index, Cobb angle) and CT analyses. Wilcoxon rank sum test, sign test and Fischer's exact test were used for statistical evaluation.
Results: A significant reduction in pain intensity (VAS) from preoperative 8.0 to 1.6 after 12 months and significant improvement in activity level (ODI) from preoperative 79.0 to 30.5 % after 12 months were revealed. Radiologically, the mean kyphotic angle according to Cobb showed significant improvements from preoperative 9.1° to 8.0° after 12 months. A vertebral body subsidence was revealed in only one case (6.7 %). No changes in the position of the posterior wall were revealed. No cement leakage or perioperative complications were seen.
Conclusion: As a safe and effective procedure, the use of intravertebral expandable titanium mesh cages presents a valuable alternative to usual intravertebral stabilization procedures for incomplete osteoporotic burst fractures and bears the potential to reduce cement-associated complications.
Trial Registration: German Clinical Trials Register (DKRS) DRKS00008833 .
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644291 | PMC |
| http://dx.doi.org/10.1186/s13018-015-0322-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intracranial Hypotension Mechanism and Implant Retention Procedure for Patients With Titanium Mesh Exposure.
Oper Neurosurg (Hagerstown)
January 2025
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Background And Objectives: The study aimed to investigate the potential pathogenesis and present an implant retention procedure for patients with titanium mesh exposure after cranioplasty.
Methods: The clinical data were obtained from 26 consecutive cases with titanium mesh exposure who underwent surgical treatment between 2018 and 2023. These patients' medical records, scalp photographs, operative notes, and outcomes were retrospectively analyzed.
3D-printed porous titanium versus polyetheretherketone cages in lateral lumbar interbody fusion: a systematic review and meta-analysis of subsidence.
Front Med (Lausanne)
December 2024
Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Article Synopsis
- Cage subsidence can negatively affect lumbar fusion procedures, with material selection (PEEK vs. 3D-Ti) influencing this issue; the study aims to compare their subsidence rates.
- The systematic search reviewed 265 patients from three high-quality studies, focusing on cage subsidence and classified subsidence rates using a specific method.
- Results indicated that 3D-Ti cages have a significantly lower rate of subsidence compared to PEEK cages, with less severe subsidence and better overall performance.
Impact of titanium mesh cage slotting width on anterior cervical corpectomy and fusion for compression cervical spondylosis with MRI T2WI hyperintensity: a one-year follow-up study.
J Orthop Surg Res
December 2024
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Background: Anterior cervical corpectomy and fusion (ACCF) is a standard surgical procedure for cervical spondylosis with spinal cord compression (CSWSCC), especially in patients with intensity on T2-weighted imaging high signal (T2WIHS). The titanium mesh cage (TMC) utilized in this procedure is essential in stabilizing the spine; however, the optimal slotting width of the TMC remains unclear.
Objective: This study aimed to investigate the impact of TMC slotting width on the clinical and radiological outcomes of ACCF in patients with spinal cord compression type cervical spondylosis with intensity on T2WIHS (CST2WIHS).
Surgical management of costal margin rupture associated with intercostal hernia: Evolution of techniques.
J Trauma Acute Care Surg
October 2024
From the Sheffield Teaching Hospitals NHS Foundation Trust (P.W., J.N.R., S.T., J.G.E.), Sheffield, England; Erasmus Medical Centre (M.M.E.W.), Rotterdam, The Netherlands; and University Hospital of Southampton NHS Foundation Trust (A.T.).
Introduction: Costal margin rupture (CMR) injuries in association with intercostal hernia (IH) are rare and symptomatic and provide a significant surgical challenge. Surgical failure rates up to 60% are reported, and optimal techniques are unclear. We have characterized these injuries and describe the evolution of our surgical management techniques.
View Article and Find Full Text PDFNeglected growing skull fracture presenting in adulthood: A case report.
Int J Surg Case Rep
December 2024
Department of Radiology, B and B Hospital, Gwarko, Lalitpur, Nepal.
Introduction And Importance: Growing skull fracture is one the rarest complication of skull fracture. They are identified mostly in infancy and children's, secondary to head trauma but there exist possibility of missed diagnosis in childhood and patient presenting in adulthood with delayed complications. Hence timely diagnosis and prompt management is mandatory.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!