[The effect of titanium mesh cage on maintenance of thoracolumbar and lumbar lordosis in anterior instrumentation for thoracolumbar and lumbar scoliosis].
OBJECTIVE
To evaluate the clinical importance of titanium mesh cage (TMC) in anterior instrumentation for scoliosis.


METHODS
Thirty-six consecutive patients with thoracolumbar/lumbar adolescent idiopathic scoliosis were treated with anterior derotation and instrumentation using autologous bone grafting and TMC for interbody fusion. The average age of patients was 17 years (ranged from 14 to 22 years), in which 5 cases were male and 31 cases were female.


RESULTS
The coronal Cobb angle before surgery, 2 weeks after surgery, and 13 months at the follow-up was measured as 56 degrees , 15 degrees , and 18 degrees respectively, while the thoracic kyphosis from T(5) to T(12) was 30 degrees , 33 degrees , and 37 degrees respectively, and the lumbar lordosis from L(1) to S(1) was 46 degrees , 56 degrees , 51 degrees . There were no death, infection, implant failures or collapse of intervertebral space. Intraoperative injury of lacteal occurred in one patient, but no postoperative complications happened. One of two patients who had pleural effusion was managed with close drainage. Exudative pleurisy occurred in one patient, the sympathectomy effect occurred in three patients who presented asymmetry of skin temperature and resolved in short term.


CONCLUSIONS
Coronal and sagittal alignment can be well corrected and maintained with TMC in anterior scoliosis surgery, collapse of intervertebral space and lumbar kyphosis can be prevented.
Qiu
Yong
Y
Spine Service, Gulou Hospital, Nanjing University Medical School, Nanjing 210008, China. scoliosis2002@sina.com
He
Yong-xiong
YX
Wang
Bin
B
Yu
Yang
Y
Zhu
Ze-zhang
ZZ
Qian
Bang-ping
BP
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D009984:Orthopedic Fixation Devices; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*; D014025:Titanium
D014025:Titanium