Article
Sagittal profile reconstruction after spinal injuries with a non-distractible vertebral body replacement vs extendable spacers – A retrospective analysis
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Published: | April 28, 2011 |
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Objective: In reconstructive surgery for traumatic thoracic and lumbar spine injuries, known complications are secondary deformation and implant failure. One of the first interbody spacers was the Moss-CageTM (Depuy). This non-distractible titanium spacer was the forerunner for present extendable spacers. In 1998 the first distractible spacer was introduced: the X-tenzTM (Königsee). It was the aim of this retrospective radiological study to analyze the advantages and disadvantages of the different spacers.
Methods: 63 patients with injuries of the thoracic and lumbar spine were treated at our institution between June 1997 and January 2001. The Moss-CageTM was implanted in 34 patients and the X-tenzTM cage in 29 patients. Clinical and surgical data were collected, as well as pre- and post-operative x-rays to assess the sagittal spinal profile and the development of secondary deformation after patient mobilization. X-rays were obtained at 3, 6, and 12 months after surgery.
Results: Initial reconstruction of the sagittal spinal profile was achieved with both implants in all patients. Secondary deformation was observed in 9 patients in the Moss-CageTM-group due to implant pistoning in adjacent vertebra. Pistoning was only observed in the X-tenzTM group in one patient (p=0.0157, two-sided Chi-Square test). Furthermore, in the Moss-CageTM-group, one patient suffered implant failure after 6 months with fracture of a pedicle screw. With the exception of this patient bony fusion was observed in all patients after 3 months.
Conclusions: The distractible X-tenzTM proved superior for stable reconstruction of the sagittal spinal profile after spinal column injury.