title: Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages.
abstract: The purpose of this study was to investigate the outcome of expandable titanium cage implantation in large defects caused by acute vertebral osteomyelitis. Twenty-five patients with acute single or multilevel spondylodiscitis were treated after radical débridement and posterior instrumentation with an anterior expandable titanium cage and bone grafting. Clinical, laboratory and radiological follow-up continued for 36 months. Within the postoperative course there was no recurrence of spinal infection. The final radiological examination showed successful fusion in all cases without implant loosening or failure. At the final follow-up after 36 months the Oswestry Disability Index was 23 +/- 14 and the pain visual analogue scale 2.1 +/- 1.7. This study reveals healing and improved function after expandable titanium cage implantation in all patients. Prerequisites for optimal healing include radical débridement, provision of stability for weight-bearing, adequate bone grafting and correction of deformity using rigid implants.
authors.affiliation: Charité-Campus Benjamin Franklin, Center for Trauma and Reconstructive Surgery, Berlin, Germany.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Robinson
authors.forename: Sven Kevin
authors.initials: SK
authors.lastname: Tschoeke
authors.forename: Ralph
authors.initials: R
authors.lastname: Kayser
authors.forename: Heinrich
authors.initials: H
authors.lastname: Boehm
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Heyde
mesh_terms: D000208:Acute Disease; D000368:Aged; D016025:Bone Transplantation; D003646:Debridement; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008297:Male; D010019:Osteomyelitis / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013131:Spine / Q000473:pathology / Q000601:surgery*; D014025:Titanium
chemical_list: D014025:Titanium