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

a–g Clinical case with X-ray imaging and MRI. Legend: Preoperative (a–c), postoperative (d, e) and X-ray imaging as well as MRI after 12 months (f, g) of an osteoporotic incomplete L2 burst fracture and L3 compression fracture without involvement of the posterior wall and stabilization using two cement-augmented titanium mesh cages (preoperative VAS 10.0, ODI 70.0 %; 12 months postoperative VAS 2.0, ODI 34.0 %)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: a–g Clinical case with X-ray imaging and MRI. Legend: Preoperative (a–c), postoperative (d, e) and X-ray imaging as well as MRI after 12 months (f, g) of an osteoporotic incomplete L2 burst fracture and L3 compression fracture without involvement of the posterior wall and stabilization using two cement-augmented titanium mesh cages (preoperative VAS 10.0, ODI 70.0 %; 12 months postoperative VAS 2.0, ODI 34.0 %)

Mentions: The preoperative bone density measurement (DXA) revealed a mean BMD of 0.7654 g/cm2 (SD ±0.08, min. 0.91, max. 0.52), a mean T-score of −3.6 (SD ±0.68, min. −2.0, max. −5.4) and a mean Z-score of −1.8 (SD ±0.68, min. −0.9, max. −3.9). Figure 4 shows radiological progress diagnostics.Fig. 4


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–g Clinical case with X-ray imaging and MRI. Legend: Preoperative (a–c), postoperative (d, e) and X-ray imaging as well as MRI after 12 months (f, g) of an osteoporotic incomplete L2 burst fracture and L3 compression fracture without involvement of the posterior wall and stabilization using two cement-augmented titanium mesh cages (preoperative VAS 10.0, ODI 70.0 %; 12 months postoperative VAS 2.0, ODI 34.0 %)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: a–g Clinical case with X-ray imaging and MRI. Legend: Preoperative (a–c), postoperative (d, e) and X-ray imaging as well as MRI after 12 months (f, g) of an osteoporotic incomplete L2 burst fracture and L3 compression fracture without involvement of the posterior wall and stabilization using two cement-augmented titanium mesh cages (preoperative VAS 10.0, ODI 70.0 %; 12 months postoperative VAS 2.0, ODI 34.0 %)
Mentions: The preoperative bone density measurement (DXA) revealed a mean BMD of 0.7654 g/cm2 (SD ±0.08, min. 0.91, max. 0.52), a mean T-score of −3.6 (SD ±0.68, min. −2.0, max. −5.4) and a mean Z-score of −1.8 (SD ±0.68, min. −0.9, max. −3.9). Figure 4 shows radiological progress diagnostics.Fig. 4

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