title: Anterior operation for unstable thoracolumbar and lumbar burst fractures: tricortical autogenous iliac bone versus titanium mesh cage.
abstract: METHODS
  We retrospectively compared 25 cases that used the autogenous iliac bone grafting with 18 cases that used a titanium mesh cage for reconstruction of the vertebral body.
  
  
  OBJECTIVE
  To analyze clinical and radiographic results of the autogenous iliac bone and a titanium mesh cage used to reconstruct the vertebral body.
  
  
  BACKGROUND
  Grafting of the autogenous iliac bone as a strut bone has been traditionally applied for reconstruction of the spine using anterior approach. Although grafting the autogenous iliac bone as a strut bone achieves a high bone fusion rate, it has reported complications in the donor site. For this reason, bone fusion with a mesh cage has been introduced.
  
  
  METHODS
  Between March 2000 and December 2010, 43 cases that underwent decompression and instrumented fusion for unstable burst fractures using the anterior approach were enrolled. Levels of injury were T12 in 8 cases, L1 in 19 cases, L2 in 11 cases, and L3 in 5 cases. The mean follow-up period was 64.5 months (range, 14-129 mo).
  
  
  RESULTS
  The local kyphotic angle in the group that used the tricortical autogenous iliac bone (group A) was measured 24.81±2.27 degrees preoperatively and 4.95±0.61 degrees at the last follow-up. The angle in the group that used a titanium mesh cage (group B) was 25.21±1.55 degrees preoperatively and 3.9±0.43 degrees at the last follow-up. Both groups obtained bone fusion of grade I and II by Bridwell fusion criteria. The operation site visual analog scale and Korean Oswestry disability index did not differ significantly between 2 groups. Donor site visual analog scale and the operation time was significantly in favor of group B (P<0.05).
  
  
  CONCLUSIONS
  Titanium mesh cage filled with the autogenous cancellous bone shortened operation time and reduced the risk of complications in the donor site compared with the group that used the tricortical iliac bone.
authors: *Department of Orthopaedic Surgery, Hanyang University College of Medicine †Department of Pharmacology, College of Medicine and Institute of Biomedical Science, Hanyang University, Seoul, Korea.
authors: Chang-Nam
authors: CN
authors: Kang
authors: Jae-Lim
authors: JL
authors: Cho
authors: Seung-Pyo
authors: SP
authors: Suh
authors: Youn-Ho
authors: YH
authors: Choi
authors: Ju-Seop
authors: JS
authors: Kang
authors: Yee-Suk
authors: YS
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000209:etiology; D019736:Prostheses and Implants; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D014025:Titanium / Q000494:pharmacology*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium