Radiologic stability of titanium mesh cages for anterior spinal reconstruction following thoracolumbar corpectomy.
BACKGROUND
This work evaluated the radiologic stability of titanium mesh cages (TMCs) when used for single-level corpectomy reconstruction of thoracic and thoracolumbar spine.


METHODS
Thirty-one patients underwent reconstruction for acute fractures (n = 15), posttraumatic deformity reconstruction (n = 10), neoplastic disorders (n = 4), and infection (n = 2). The cages were placed after corpectomy and excision of the adjacent intervertebral discs. Additional stabilization devices included anterior plates alone (n = 18), anterior double screw and rod constructs alone (n = 9), a single anterior rod system (n = 1), posterior stabilization alone (n = 6), and additional posterior stabilization (n = 2).


RESULTS
Mean kyphosis correction was from 16 degrees to 5 degrees with 3 degrees of recurrence at 1-year follow-up (P < 0.0001 for both postoperative and final follow-up). In patients with greater initial kyphosis (>20 degrees ), mean correction was from 33 degrees to 10 degrees without recurrence (P = 0.004). Distance between adjacent vertebral bodies improved by 13 mm after cage placement, with a mean of 2mm of settling at final follow-up. There was one asymptomatic cage fracture without evidence of other problems. Two patients had construct failure after complex three-dimensional deformities were inadequately corrected and the cages had been placed in an angulated position.


CONCLUSIONS
This report suggests that TMCs are a sound reconstruction alternative after thoracic and thoracolumbar corpectomy at a single level and may prevent complications associated with the harvest and use of large structural autografts for these reconstructions. Failure to correctly align the spine so the cage can be vertically placed is a contraindication to the use of TMCs.
Robertson
Peter A
PA
Auckland Hospital, Auckland, New Zealand. p.a.robertson@xtra.co.nz
Rawlinson
Helen J
HJ
Hadlow
Alastair T
AT
D016025:Bone Transplantation / Q000009:adverse effects; D000075202:Contraindications; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000706:statistics & numerical data*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D010000:Osteitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D011859:Radiography; D015203:Reproducibility of Results; D013121:Spinal Curvatures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013526:Surgical Mesh / Q000009:adverse effects / Q000706:statistics & numerical data*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014025:Titanium; D014182:Transplantation, Autologous / Q000009:adverse effects; D016896:Treatment Outcome
D014025:Titanium