title: Late stress fracture of a well-consolidated strut graft after total spondylectomy in the thoracolumbar spine.
abstract: METHODS
  A retrospective study of three patients of delayed stress fracture of anterior strut graft after total spondylectomy.
  
  
  OBJECTIVE
  The aim of this paper is to report a possible risk of removal of instrumentation after total spondylectomy.
  
  
  BACKGROUND
  Solid fusion of anterior column usually means stable spine and reports of delayed stress fracture of an anterior strut graft are rare.
  
  
  METHODS
  The authors reviewed the medical history and imaging data of three patients who suffered late stress fracture after total spondylectomy.
  
  
  RESULTS
  All three patients had total spondylectomy as a treatment of malignant tumor of thoracic spine. After removal of posterior instrumentation, they sustained stress fracture of the anterior strut, which is already incorporated well.
  
  
  CONCLUSIONS
  Removal of instrumentation may cause stress fracture of anterior strut grafts after total spondylectomy. Solid fusion of anterior column usually indicates stable spinal column and reported delayed stress fracture of anterior strut graft is rare. The authors reviewed the medical history and images of three cases with late stress fracture after total spondylectomy. All three cases had total spondylectomy as a treatment of malignant tumor of thoracic spine. After removal of posterior instrumentation, they had stress fracture of anterior strut, which is already incorporated well. Removal of posterior instrumentation may cause stress fracture of anterior strut grafts after total spondylectomy.
authors.affiliation: Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata City 951-8510, Japan. itakui@me.com
authors.forename: Takui
authors.initials: T
authors.lastname: Ito
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
authors.forename: Takao
authors.initials: T
authors.lastname: Honma
authors.forename: Toru
authors.initials: T
authors.lastname: Hirano
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D015775:Fractures, Stress / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*