title: Cementless fixation of osteoporotic VCFs using titanium mesh implants (OsseoFix): preliminary results.
abstract: BACKGROUND
  Vertebral compression fractures (VCFs) affect 20% of people over the age of 70 with increasing incidence. Kypho-/vertebroplasty as standard operative procedures are associated with limitations like cement leakage, limited reduction capabilities, and risk for adjacent fractures. To address these shortcomings, we introduce a new minimal invasive cementless VCF fixation technique.
  
  
  METHODS
  Four patients (72.3 years, range 70-76) with VCFs type AO/Müller A1.3 and concomitant osteoporosis were treated by minimal invasive transpedicular placement of two intervertebral mesh cages for fracture reduction and maintenance. Follow-up included functional/radiological assessment and clinical scores and averaged 27.7 months (24-28).
  
  
  RESULTS
  Endplate reduction was achieved in all cases (mean surgery time: 28.5 minutes). Kyphotic (KA) and Cobb angle revealed considerable improvements postoperatively (KA 14.5° to 10.7°/Cobb 10.1° to 8.3°). Slight loss of vertebral reduction (KA: 12.6°) and segment rekyphosis (Cobb: 10.7°) were observed for final follow-up. Pain improved from 8.8 to 2.8 (visual analogue scale). All cases showed signs of bony healing. No perioperative complications and no adjacent fractures occurred.
  
  
  CONCLUSIONS
  Preliminary results in a small, selected patient collective indicate the ability of bony healing for osteoporotic VCFs. Cementless fixation using intravertebral titanium mesh cages revealed substantial pain relief, adequate reduction, and reduction maintenance without complications. Trial registration number is DRKS00005657, German Clinical Trials Register (DKRS).
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University of Rostock Medical Center, Schillingallee 35, 18057 Rostock, Germany.
authors.forename: Anica
authors.identifier: 0000-0002-3189-0849
authors.initials: A
authors.lastname: Eschler
authors.affiliation: Department of Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch Straße, 17475 Greifswald, Germany.
authors.forename: Stephan Albrecht
authors.initials: SA
authors.lastname: Ender
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University of Rostock Medical Center, Schillingallee 35, 18057 Rostock, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ulmar
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University of Rostock Medical Center, Schillingallee 35, 18057 Rostock, Germany.
authors.forename: Philipp
authors.identifier: 0000-0001-7174-1429
authors.initials: P
authors.lastname: Herlyn
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University of Rostock Medical Center, Schillingallee 35, 18057 Rostock, Germany.
authors.forename: Thomas
authors.identifier: 0000-0002-0536-8045
authors.initials: T
authors.lastname: Mittlmeier
authors.affiliation: Department of Trauma, Orthopedic and Reconstructive Surgery, Klinikum München Harlaching, Sanatoriumsplatz 2, 81545 München, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Gradl
mesh_terms: D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D005592:Fracture Fixation; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D019736:Prostheses and Implants; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014025:Titanium / Q000627:therapeutic use*
chemical_list: D001843:Bone Cements; D014025:Titanium
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