Artikel
Experience with the X-TENZTM expandable spinal cage in trauma of the thoracic and lumbar spine
Erfahrungen mit dem X-TENZTM Expandable Spinal Cage bei Traumen der thorakalen und lumbalen Wirbelsäule
Suche in Medline nach
Autoren
Veröffentlicht: | 23. April 2004 |
---|
Gliederung
Text
Objective
Vertebral body replacement using different types of implants has gained large acceptance due to its proven advantages: (e. g. immediate stability, good long-term correction). Different reasons have led to a more frequent use of expandable cages compared to rigid implants: 1. less destruction of anatomical structures due to smaller approaches (especially for endoscopic procedures), 2. easier handling (no intraoperative tailoring, easy correction, optimal adaptation to the defect), 3. reduced operation time. The use of expandable implants might also offer: 1. a smaller rate of correction loss, 2. the use as a stand-alone-procedure for limited indications. Regarding these aspects we present our special experience with the Acromed DePuy X-TENZTM Expandable Spinal Cage.
Methods
From 1 / 2001 to 06 / 2003 we used a standardized procedure for fractured vertebral body replacement (vertebrae ranging from Th11 to L4) using a DePuy X-TENZTM Expandable Cage in 34 patients suffering from traumatic vertebral body fracture. Further augmentation was achieved by standard dorsal instrumentation. We used a ventral plate in 1 case though and restricted our efforts to sole vertebral body replacement in another case. Radiological and clinical follow-up was estimated every 3 months. Our results were compared to data from current literature about rigid implants.
Results
Handling of the X-TENZTM cage was significantly easier compared to rigid cages. The perioperative morbidity was low (2,9%), there was no operative mortality. One patient had to be reoperated for cage dislocation. Follow-up showed a realigned, regular sagital profile with a very low rate of consecutive correction loss (mean: < 3 degrees) in all other patients, probably due to the special square shape and mechanically stable construction of the implant promising less impaction into the adjacent vertebrae. Manifest signs of peri-implant osseous consolidation could be seen 12 months after operation in the first patients.
Conclusions
Based on our data about expandable cages compared to the literature concerning rigid implants, the use of expandable cages in vertebral body replacement seems to offer some advantages consisting of: less use of time, better handling and maybe better sparing of anatomical structures. Special features of the X-TENZTM Expandable Cage promise less impaction into the adjacent vertebrae resulting in a very low rate of correction loss.