title: Harms titanium mesh cage fracture.
abstract: Interbody fusion has become a mainstay of surgical management for lumbar fractures, tumors, spondylosis, spondylolisthesis and deformities. Over the years, it has undergone a number of metamorphoses, as novel instrumentation and approaches have arisen to reduce complications and enhance outcomes. Interbody fusion procedures are common and successful, complications are rare and most often do not involve the interbody device itself. We present here a patient who underwent an anterior L4 corpectomy with Harms cage placement and who later developed a fracture of the lumbar titanium mesh cage (TMC). This report details the presentation and management of this rare complication, as well as discusses the biomechanics underlying this rare instrumentation failure.
authors.affiliation: Orthopedics, Royal Derbyshire Infirmary, Derby, UK.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Klezl
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Bagley
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Bookland
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Wolinsky
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rezek
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D004868:Equipment Failure; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D007796:Laminectomy / Q000295:instrumentation / Q000379:methods; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D011128:Polyradiculopathy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000601:surgery; D019736:Prostheses and Implants / Q000009:adverse effects*; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D011859:Radiography; D012086:Reoperation; D013115:Spinal Canal / Q000293:injuries / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D013126:Spinal Nerve Roots / Q000293:injuries / Q000503:physiopathology; D013314:Stress, Mechanical; D014025:Titanium; D016896:Treatment Outcome; D016474:Weight-Bearing
chemical_list: D014025:Titanium