Single stage anterior reconstruction using titanium mesh cages in neglected kyphotic tuberculous spondylodiscitis of the cervical spine.
Cervical tuberculous spondylodiscitis is a serious, hazardous disorder and to our knowledge, hardly any reports focused on the use of titanium mesh cages in its treatment. The aim of this work is to evaluate the efficacy of using a titanium mesh cage compared to iliac crest grafting regarding correction of the deformity, fusion rate and to report the incidence of complications. A prospective, non-randomized multicentre study of 30 patients with cervical tuberculous spondylodiscitis presenting with a neglected kyphotic deformity. The average age was 44.5 years; 18 had neurological deficits. All patients had a single stage radical debridement, decompression, and instrumentation. The anterior column was reconstructed with a titanium mesh cage in 16 patients (Group 1) and an autogenous iliac bone strut graft in 14 (Group 2). Both groups were followed for a minimum of 2 years. Group 1 showed a better sagittal profile and local kyphosis was corrected from an average of 36° (10°-62°) to an average of -6° (+4° to -16°) compared to Group 2 corrected from an average of 30° (6°-48°) to an average of -1° (+2° to -13°). Group 1 patients showed a solid bony fusion without any recurrence of infection while Group 2 showed a higher incidence of nonunion and of persistent donor site morbidity. The use of titanium mesh cages effectively restores the sagittal profile while adding immediate stability. There is no donor site morbidity, recurrence, or persistence of infection associated with their implantation.
Koptan
Wael
W
Orthopaedic Department, Faculty of Medicine, Cairo University, Giza, Egypt. waelkoptan@yahoo.com
Elmiligui
Yasser
Y
Elsharkawi
Mohammad
M
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D015299:Discitis / Q000601:surgery*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D013526:Surgical Mesh; D014025:Titanium; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000601:surgery*
D014025:Titanium