Healing of autologous bone in a titanium mesh cage used in anterior column reconstruction after total spondylectomy.
METHODS
Autologous bone inside a titanium mesh cage, used as an anterior strut in a reconstruction after total spondylectomy, was histologically examined in a postmortem specimen.


OBJECTIVE
To determine whether the autologous bone inside the titanium mesh cage attained fusion and remodeling in a combined reconstruction, consisting of an anterior titanium mesh cage with posterior multilevel instrumentation, after total spondylectomy.


BACKGROUND
There are few previous reports on the histologic analysis of the bone inside a titanium mesh cage when it is used clinically as an anterior column support in a spinal fusion. Attaining biologic bony fusion is desirable for long-term stability after total spondylectomy.


METHODS
A postmortem specimen from a 16-year-old boy with Ewing's sarcoma at T6, who died of lung metastasis 16 months after total spondylectomy and combined reconstruction, was analyzed.


RESULTS
Histologic examination revealed many viable cells and normal lamella of trabecular bone formation in the grafted bone inside the mesh. Consecutive trabecular cancellous bony fusion between the grafted bone and the adjacent vertebral bodies was achieved.


CONCLUSIONS
Remodeling and fusion of the grafted bone inside the titanium mesh cage was observed. Combined reconstruction using an anterior titanium mesh cage with posterior multilevel instrumentation after total spondylectomy makes it possible to achieve biologic fusion of the bone inside the mesh cage with the adjacent vertebral bodies.
Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
Tomoyuki
T
Akamaru
Norio
N
Kawahara
Hiroyuki
H
Tsuchiya
Tadayoshi
T
Kobayashi
Hideki
H
Murakami
Katsuro
K
Tomita
D000293:Adolescent; D001861:Bone Regeneration; D003131:Combined Modality Therapy; D018450:Disease Progression; D017809:Fatal Outcome; D006085:Graft Survival; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D009364:Neoplasm Recurrence, Local; D019736:Prostheses and Implants; D012086:Reoperation; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery; D014025:Titanium; D014182:Transplantation, Autologous
D014025:Titanium