Comparison of Clinical and Radiologic Results between Expandable Cages and Titanium Mesh Cages for Thoracolumbar Burst Fracture.
OBJECTIVE
A thoracolumbar burst fracture is usually unstable and can cause neurological deficits and angular deformity. Patients with unstable thoracolumbar burst fracture usually need surgery for decompression of the spinal canal, correction of the angular deformity, and stabilization of the spinal column. We compared two struts, titanium mesh cages (TMCs) and expandable cages.


METHODS
33 patients, who underwent anterior thoracolumbar reconstruction using either TMCs (n=16) or expandable cages (n=17) between June 2000 and September 2011 were included in this study. Clinical outcome was measured by visual analogue scale (VAS), American Spinal Injury Association (ASIA) scale and Low Back Outcome Score (LBOS) for functional neurological evaluation. The Cobb angle, body height of the fractured vertebra, the operation time and amount of intra-operative bleeding were measured in both groups.


RESULTS
In the expandable cage group, operation time and amount of intraoperative blood loss were lower than that in the TMC group. The mean VAS scores and LBOS in both groups were improved, but no significant difference. Cobb angle was corrected higher than that in expandable cage group from postoperative to the last follow-up. The change in Cobb angles between preoperative, postoperative, and the last follow-up did not show any significant difference. There was no difference in the subsidence of anterior body height between both groups.


CONCLUSIONS
There was no significant difference in the change in Cobb angles with an inter-group comparison, the expandable cage group showed better results in loss of kyphosis correction, operation time, and amount of intraoperative blood loss.
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Gwang-Jun
GJ
Lee
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Jung-Kil
JK
Lee
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Hyuk
H
Hur
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Jae-Won
JW
Jang
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Tae-Sun
TS
Kim
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Soo-Han
SH
Kim
Cage; Corpectomy; Fracture; Kyphosis; Lumbar; Thoracolumbar