title: Radiological Results and Clinical Patient Outcome After Implantation of a Hydraulic Expandable Vertebral Body Replacement following Traumatic Vertebral Fractures in the Thoracic and Lumbar Spine: A 3-Year Follow-Up.
abstract: METHODS
  A prospective monocentric study.
  
  
  OBJECTIVE
  The aim of the current study was the analysis of patient outcome and radiological results 3 years after implantation of a hydraulic expandable vertebral body replacement (VBR) system.
  
  
  BACKGROUND
  Around 70% to 90% of all traumatic spinal fractures are located in the thoracic and lumbar spine. Dorso-ventral stabilization is a frequently used procedure in traumatic vertebral body fracture treatment. VBR systems can be used to bridge bony defects. In the current study, a new VBR expanded by water pressure with adjustable endplates is used.
  
  
  METHODS
  All patients who suffered a singular traumatic fracture to a thoracic or lumbar vertebral body (Th 5-L 5) in the period from November 2009 to December 2010 and (i) underwent dorsal instrumentation and (ii) afterwards received the implantation of a hydraulic VBR were included in this study. The clinical outcome (visual analogue scale [VAS] spine score, questionnaire) and radiological findings (sagittal angle, implant subsidence, and implant position) 3 years after implantation were analyzed.
  
  
  RESULTS
  The follow-up was successful for n = 47 patients (follow-up rate: 89%). Most of the patients (n = 40) were "generally/very satisfied" with their outcome. The mean rating of the VAS spine score was 65.2 ± 23.1 (range: 20.5-100.0). The analysis of the radiological data showed an average subsidence of the implants of 1.1 ± 1.2 mm (range 0.0-5.0 mm). After the initial operation, the local sagittal angle remained stable in the follow-up 3 years later both for the thoracic spine and lumbar spine. Furthermore, no change in the implant's position was observed.
  
  
  CONCLUSIONS
  The implantation of a hydraulically expandable VBR allows a permanent stable fixation after traumatic fractures of the thoracic and lumbar spine.
  
  
  METHODS
  2.
authors.affiliation: Department of Trauma Surgery and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kreinest
authors.affiliation: Department of Trauma Surgery and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.|Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Schmahl
authors.affiliation: Department of Trauma Surgery and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Grützner
authors.affiliation: Department of Trauma Surgery and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Matschke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D016103:Spinal Fractures / Q000601:surgery*; D013131:Spine; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult