Limits...
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

Titanium mesh cages (OsseoFix®) with technical specifications [picture copyright: Alphatec Spine Inc., Carlsbad, CA, USA]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Titanium mesh cages (OsseoFix®) with technical specifications [picture copyright: Alphatec Spine Inc., Carlsbad, CA, USA]

Mentions: Vertebral body stabilization using the titanium mesh cages in the previously described manner was carried out in all cases [29]. At present, solitary use of the intravertebral expandable titanium mesh cages (OsseoFix®) using only bone cement is authorized. The mesh cages consist of a combination of titanium alloy (Ti-6Al-4V, ASTM F136) with pure titanium (Ti-CP2, ASTM F67) and are specified for use in the area of T1 to L5. Three cage sizes are available for selection, which have an original diameter (unexpanded) of 4.5, 5.5 and 7.0 mm (Fig. 3).Fig. 3


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)

Titanium mesh cages (OsseoFix®) with technical specifications [picture copyright: Alphatec Spine Inc., Carlsbad, CA, USA]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Titanium mesh cages (OsseoFix®) with technical specifications [picture copyright: Alphatec Spine Inc., Carlsbad, CA, USA]
Mentions: Vertebral body stabilization using the titanium mesh cages in the previously described manner was carried out in all cases [29]. At present, solitary use of the intravertebral expandable titanium mesh cages (OsseoFix®) using only bone cement is authorized. The mesh cages consist of a combination of titanium alloy (Ti-6Al-4V, ASTM F136) with pure titanium (Ti-CP2, ASTM F67) and are specified for use in the area of T1 to L5. Three cage sizes are available for selection, which have an original diameter (unexpanded) of 4.5, 5.5 and 7.0 mm (Fig. 3).Fig. 3

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