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Fracture care using percutaneously applied titanium mesh cages (OsseoFix®) for unstable osteoporotic thoracolumbar burst fractures is able to reduce cement-associated complications-results after 12 months.

Ender SA, Eschler A, Ender M, Merk HR, Kayser R - J Orthop Surg Res (2015)

Bottom Line: A significant reduction in pain intensity (VAS) from preoperative 8.0 to 1.6 after 12 months and significant improvement in activity level (ODI) from preoperative 79.0 to 30.5 % after 12 months were revealed.Radiologically, the mean kyphotic angle according to Cobb showed significant improvements from preoperative 9.1° to 8.0° after 12 months.As a safe and effective procedure, the use of intravertebral expandable titanium mesh cages presents a valuable alternative to usual intravertebral stabilization procedures for incomplete osteoporotic burst fractures and bears the potential to reduce cement-associated complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch Straße, 17475, Greifswald, Germany. stephan.ender@gmx.net.

ABSTRACT

Background: Despite the known demographic shift with expected doubled rate of vertebral body fractures by the year 2050, a standardized treatment concept for traumatic and osteoporotic incomplete burst fracture of the truncal spine does not exist. This study aims to determine whether minimally invasive fracture care for incomplete osteoporotic thoracolumbar burst fractures using intravertebral expandable titanium mesh cages is a suitable procedure and may provide improved safety in terms of cement-associated complications in comparison to kyphoplasty procedure.

Methods: In 2011/2012, 15 patients (10 women, 5 men; mean age 77) with 15 incomplete osteoporotic thoracolumbar burst fractures (T10 to L4) were stabilized using intravertebral expandable titanium mesh cages (OsseoFix®) as part of a prospective study. X-ray, MRI and bone density measurements (DXA) were performed preinterventionally. The clinical and radiological results were evaluated preoperatively, postoperatively and after 12 months according to the visual analogue scale (VAS), the Oswestry Disability Index (ODI), X-ray (Beck Index, Cobb angle) and CT analyses. Wilcoxon rank sum test, sign test and Fischer's exact test were used for statistical evaluation.

Results: A significant reduction in pain intensity (VAS) from preoperative 8.0 to 1.6 after 12 months and significant improvement in activity level (ODI) from preoperative 79.0 to 30.5 % after 12 months were revealed. Radiologically, the mean kyphotic angle according to Cobb showed significant improvements from preoperative 9.1° to 8.0° after 12 months. A vertebral body subsidence was revealed in only one case (6.7 %). No changes in the position of the posterior wall were revealed. No cement leakage or perioperative complications were seen.

Conclusion: As a safe and effective procedure, the use of intravertebral expandable titanium mesh cages presents a valuable alternative to usual intravertebral stabilization procedures for incomplete osteoporotic burst fractures and bears the potential to reduce cement-associated complications.

Trial registration: German Clinical Trials Register (DKRS) DRKS00008833 .

No MeSH data available.


Related in: MedlinePlus

a, b Representation of the determination of the α-kyphotic angle and γ-kyphotic angle
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Fig2: a, b Representation of the determination of the α-kyphotic angle and γ-kyphotic angle

Mentions: Clinical and radiological follow-up was carried out 3 days postoperatively and after 12 months (min. 12, max. 15). The clinical evaluation included re-evaluation of the VAS and the ODI. The radiological evaluation was carried out by means of diagnostic X-ray of the thoracolumbar region in the standing position in two planes and postoperative CT scans. For quantitative evaluation of the vertebral body deformity, the Beck Index [26] (anterior vertebral height to posterior vertebral height), the vertebral kyphotic angle (α-angle) and the regional kyphotic angle (γ-angle) [27] according to Cobb were determined (Fig. 2a, b).Fig. 2


Fracture care using percutaneously applied titanium mesh cages (OsseoFix®) for unstable osteoporotic thoracolumbar burst fractures is able to reduce cement-associated complications-results after 12 months.

Ender SA, Eschler A, Ender M, Merk HR, Kayser R - J Orthop Surg Res (2015)

a, b Representation of the determination of the α-kyphotic angle and γ-kyphotic angle
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4644291&req=5

Fig2: a, b Representation of the determination of the α-kyphotic angle and γ-kyphotic angle
Mentions: Clinical and radiological follow-up was carried out 3 days postoperatively and after 12 months (min. 12, max. 15). The clinical evaluation included re-evaluation of the VAS and the ODI. The radiological evaluation was carried out by means of diagnostic X-ray of the thoracolumbar region in the standing position in two planes and postoperative CT scans. For quantitative evaluation of the vertebral body deformity, the Beck Index [26] (anterior vertebral height to posterior vertebral height), the vertebral kyphotic angle (α-angle) and the regional kyphotic angle (γ-angle) [27] according to Cobb were determined (Fig. 2a, b).Fig. 2

Bottom Line: A significant reduction in pain intensity (VAS) from preoperative 8.0 to 1.6 after 12 months and significant improvement in activity level (ODI) from preoperative 79.0 to 30.5 % after 12 months were revealed.Radiologically, the mean kyphotic angle according to Cobb showed significant improvements from preoperative 9.1° to 8.0° after 12 months.As a safe and effective procedure, the use of intravertebral expandable titanium mesh cages presents a valuable alternative to usual intravertebral stabilization procedures for incomplete osteoporotic burst fractures and bears the potential to reduce cement-associated complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch Straße, 17475, Greifswald, Germany. stephan.ender@gmx.net.

ABSTRACT

Background: Despite the known demographic shift with expected doubled rate of vertebral body fractures by the year 2050, a standardized treatment concept for traumatic and osteoporotic incomplete burst fracture of the truncal spine does not exist. This study aims to determine whether minimally invasive fracture care for incomplete osteoporotic thoracolumbar burst fractures using intravertebral expandable titanium mesh cages is a suitable procedure and may provide improved safety in terms of cement-associated complications in comparison to kyphoplasty procedure.

Methods: In 2011/2012, 15 patients (10 women, 5 men; mean age 77) with 15 incomplete osteoporotic thoracolumbar burst fractures (T10 to L4) were stabilized using intravertebral expandable titanium mesh cages (OsseoFix®) as part of a prospective study. X-ray, MRI and bone density measurements (DXA) were performed preinterventionally. The clinical and radiological results were evaluated preoperatively, postoperatively and after 12 months according to the visual analogue scale (VAS), the Oswestry Disability Index (ODI), X-ray (Beck Index, Cobb angle) and CT analyses. Wilcoxon rank sum test, sign test and Fischer's exact test were used for statistical evaluation.

Results: A significant reduction in pain intensity (VAS) from preoperative 8.0 to 1.6 after 12 months and significant improvement in activity level (ODI) from preoperative 79.0 to 30.5 % after 12 months were revealed. Radiologically, the mean kyphotic angle according to Cobb showed significant improvements from preoperative 9.1° to 8.0° after 12 months. A vertebral body subsidence was revealed in only one case (6.7 %). No changes in the position of the posterior wall were revealed. No cement leakage or perioperative complications were seen.

Conclusion: As a safe and effective procedure, the use of intravertebral expandable titanium mesh cages presents a valuable alternative to usual intravertebral stabilization procedures for incomplete osteoporotic burst fractures and bears the potential to reduce cement-associated complications.

Trial registration: German Clinical Trials Register (DKRS) DRKS00008833 .

No MeSH data available.


Related in: MedlinePlus