VERTEBRAL BODY REPLACEMENT SYSTEMS WITH EXPANDABLE CAGES IN THE TREATMENT OF VARIOUS SPINAL PATHOLOGIES

Neurosurgery ◽  
2008 ◽  
Vol 63 (3) ◽  
pp. 537-545 ◽  
Author(s):  
Mark P. Arts ◽  
Wilco C. Peul
Keyword(s):  
Vertebral Body ◽  
Case Series ◽  
Clinical Results ◽  
Herniated Disc ◽  
Vertebral Body Replacement ◽  
Traumatic Fracture ◽  
Circumferential Fusion ◽  
Favorable Clinical Outcome ◽  
Reoperation Rates ◽  
Expandable Cages

ABSTRACT OBJECTIVE Vertebral body reconstruction after corpectomy has become a common surgical procedure. The authors describe a prospectively followed case series of patients treated with expandable cages for various indications. METHODS Sixty patients underwent single or multilevel corpectomy for degenerative stenosis (13 patients), herniated disc (7 patients), deformity (14 patients), traumatic fracture (3 patients), infection (1 patient), or tumor (22 patients). Six different expandable vertebral body systems were used in the cervical spine (41 patients), thoracic spine (15 patients), and lumbar spine (4 patients). All patients were evaluated clinically and radiographically. RESULTS Thirty-nine patients underwent single-level corpectomy, 18 patients underwent two-level corpectomy, and 3 patients underwent three-level corpectomy. Anterior reconstruction alone was performed in 30 patients; circumferential reconstruction was performed in 30 patients, 9 of whom underwent reconstruction through a posterior approach only. At the time of the final follow-up examination (mean, 9 mo), the Nurick grade improved significantly. Ninety-five percent of the patients maintained or improved their Frankel score and 67% had good clinical results. The regional angulation was corrected significantly (4.0 ± 9.0 degrees, P = 0.002), and the segment height increased significantly (3.5 ± 8.0 mm, P = 0.002). Bony fusion was achieved in 93% of the cases. Subsidence was documented in nearly half of the patients (1.4 ± 2.0 mm) and was reduced after circumferential fusion (0.9 ± 1.9 mm, P = 0.08). Eighteen patients (30%) had complications and 12 patients (20%) underwent revision surgery. CONCLUSION Expandable vertebral body replacement systems can provide solid anterior column constructs with restoration of height and sagittal alignment. Favorable clinical outcome was shown in most patients, although the complication and reoperation rates are rather high.

scholarly journals Vertebral body replacement with an expandable cage for reconstruction after spinal tumor resection

2003 ◽  
Vol 15 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Issada Thongtrangan ◽  
Raju S. V. Balabhadra ◽  
Hoang Le ◽  
Jon Park ◽  
Daniel H. Kim
Keyword(s):  
Vertebral Body ◽  
Tumor Resection ◽  
Anterior Column ◽  
Vertebral Body Replacement ◽  
Spinal Tumors ◽  
Wide Resection ◽  
Primary Tumors ◽  
Expandable Cage ◽  
Expandable Cages

Object The authors report their clinical experience with expandable cages used to stabilize the spine after verte-brectomy. The objectives of surgical treatment for spine tumors include a decrease in pain, decompression of the neural elements, mechanical stabilization of the spine, and wide resection to gain local control of certain primary tumors. Most of the lesions occur in the anterior column or vertebral body (VB). Anterior column defects following resection of VBs require surgical restoration of anterior column support. Recently, various expandable cages have been developed and used clinically for VB replacement (VBR). Methods Between January 2001 and June 2003, the authors treated 15 patients who presented with primary spinal tumors and metastatic lesions from remote sites. All patients underwent vertebrectomy, VBR with an expandable cage, and anterior instrumentation with or without posterior instrumentation, depending on the stability of the involved segment. The correction of kyphotic angle was achieved at an average of 20°. Pain scores according to the visual analog scale decreased from 8.4 to 5.2 at the last follow-up review. Patients whose Frankel neurological grade was below D attained at least a one-grade improvement after surgery. All patients achieved immediate stability postsurgery and there were no significant complications related to the expandable cage. Conclusions The advantage of the expandable cage is that it is easy to use because it permits optimal fit and correction of the deformity by in vivo expansion of the device. These results are promising, but long-term follow up is required.

scholarly journals Sagittal deformity correction with expandable cages with large endplates for thoracolumbar vertebral body replacement

2021 ◽  
Vol 1 ◽  
pp. 100421
Author(s):  
S. Motov ◽  
B. Stemmer ◽  
B. Sommer ◽  
M.N. Bonk ◽  
C. Wolfert ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Deformity Correction ◽  
Vertebral Body Replacement ◽  
Sagittal Deformity ◽  
Expandable Cages

Biomechanical Comparison of Expandable Cages for Vertebral Body Replacement in the Thoracolumbar Spine

Spine ◽  
2004 ◽  
Vol 29 (13) ◽  
pp. 1413-1419 ◽  
Author(s):  
Robert Pflugmacher ◽  
Philipp Schleicher ◽  
Jan Schaefer ◽  
Matti Scholz ◽  
Kathrin Ludwig ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Thoracolumbar Spine ◽  
Vertebral Body Replacement ◽  
Biomechanical Comparison ◽  
Expandable Cages

scholarly journals Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine

2020 ◽  
Vol 28 (1) ◽  
pp. 230949901990047
Author(s):  
Barbara Cappelletto ◽  
Fabrizia Giorgiutti ◽  
Massimo Balsano
Keyword(s):  
Vertebral Body ◽  
Primary Stability ◽  
Clinical Results ◽  
Kyphosis Angle ◽  
Analog Scale ◽  
Traumatic Injuries ◽  
Expandable Cage ◽  
Clinical Observations ◽  
Anterior Support ◽  
Expandable Cages

Purpose: For anterior spine column reconstruction after corpectomy, expandable cages offer solid anterior support and allow correction of deformity, providing excellent primary stability. To provide a larger body of clinical observations concerning the effectiveness of the approach, this retrospective study examines patients treated by corpectomy and reconstruction with an expandable cage for different pathologies. Methods: Across 5 years, 39 patients underwent vertebral reconstruction with expandable cages after single ( n = 34), double ( n = 4), or triple ( n = 1) corpectomy. Pathologies were tumors ( n = 21), fractures, or deformities in traumatic injuries ( n = 14), degenerative pathology ( n = 2), and infection ( n = 2). Levels were cervical ( n = 10), thoracic ( n = 14), and lumbar ( n = 15). All patients were evaluated clinically and radiographically. Results: There were no cases of neurologic deterioration. Nurick grade showed significant improvement at 3 months postoperative versus preoperative ( p < 0.01). Visual analog scale significantly improved preoperatively versus 3 and 12 months postoperatively (both p = 0). Regional angulation was significantly corrected, from preoperative to 3 and 12 months postoperative, at cervical, thoracic, and lumbar levels. We achieved reconstruction of the normal local anatomy with full recovery of the height of the vertebral body. Six patients (15.4%) had complications and two (5.1%) underwent revision surgery. Conclusions: In our experience, expandable cages confer stable anterior support, providing significant improvement of the segmental kyphosis angle and restoration of the original somatic height. Our clinical results are favorable, and the low rate of complications and revision accentuates the expandable cage as a valuable tool to replace the vertebral body in diverse pathologies and different spine levels.

Biomechanical comparison of expandable cages for vertebral body replacement in the cervical spine

2003 ◽  
Vol 99 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Frank Kandziora ◽  
Robert Pflugmacher ◽  
Jan Schaefer ◽  
Matti Scholz ◽  
Kathrin Ludwig ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Vertebral Body Replacement ◽  
Biomechanical Comparison ◽  
Expandable Cages

Diagnosis and management of hook of hamate fractures

2017 ◽  
Vol 43 (5) ◽  
pp. 539-545 ◽  
Author(s):  
Assaf Kadar ◽  
Allen T. Bishop ◽  
Marissa A. Suchyta ◽  
Steven L. Moran
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Clinical Findings ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
Historical Case ◽  
Treatment Groups ◽  
Diagnosis And Management ◽  
Time To Diagnosis ◽  
Hook Of Hamate

The purpose of this study was to evaluate the time to diagnosis and management of hook of hamate fractures in an era of advanced imaging. We performed a retrospective study of 51 patients treated for hook of hamate fractures. Patients were sent a quickDASH questionnaire regarding the outcomes of their treatment. Hook of hamate fractures were diagnosed with advanced imaging at a median of 27 days. Clinical findings of hook of hamate tenderness had better sensitivity than carpal tunnel-view radiographs. Nonunion occurred in 24% of patients with non-operative treatment and did not occur in the operative group. Both treatment groups achieved good clinical results, with a grip strength of 80% compared with the non-injured hand and a median quickDASH score of 2. Advanced imaging improved the time to diagnosis and treatment compared to historical case series. Nonunion is common in patients treated non-operatively. Level of evidence: IV

scholarly journals Return to Sports After Bone Marrow–Derived Cell Transplantation for Osteochondral Lesions of the Talus

Cartilage ◽  
2016 ◽  
Vol 8 (1) ◽  
pp. 80-87 ◽  
Author(s):  
Francesca Vannini ◽  
Marco Cavallo ◽  
Laura Ramponi ◽  
Francesco Castagnini ◽  
Simone Massimi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Transplantation ◽  
Case Series ◽  
Clinical Results ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
One Step ◽  
American Orthopaedic ◽  
Return To Activity

Objective Arthroscopic “one-step” technique based on bone marrow–derived cell transplantation (BMDCT) have achieved good results in repairing osteochondral lesions of the talus (OLT), overcoming important drawbacks of older techniques. It may be particularly adequate for the treatment of athletes in order to permit a safe and stable return to sports. The aim of this study was to report the results at 48 months of a series of athletes and the factors influencing the return to sports. Design Case series. A total of 140 athletes underwent a “one-step” BMDCT repair of OLT. All the patients had the cells harvested from the iliac crest, condensed and loaded on a scaffold, and then implanted. Patients were evaluated clinically by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and Halasi score. Results AOFAS score improved from 58.7 ± 13.5 preoperatively to 90.6 ± 8.6 ( P < 0.005) at 24 months, and to 90.9 ± 10.7 at 48 months. Halasi score was 6.88 ± 1.8 preinjury, 4.08 ± 1.7 preoperatively, and 5.56 ± 2.0 at final follow-up. At the final follow-up, all the patients (beside 1 failure and 3 lost) were able to return to activity and 72.8% were able to resume sports at preinjury level. Conclusions “One-step” BMDCT repair of OLT had good clinical results that was durable over time in athletes, permitting a return to sports at preinjury level in the majority of patients. The preoperative presence of impingement and articular degeneration were the main negative prognostic factors.

Flexible device for vertebral body replacement

1989 ◽  
Vol 11 (2) ◽  
pp. 113-117 ◽  
Author(s):  
J.A. Main ◽  
M.E. Wells ◽  
D.M. Spengler ◽  
A.M. Strauss ◽  
T.S. Keller
Keyword(s):  
Vertebral Body ◽  
Vertebral Body Replacement ◽  
Flexible Device

scholarly journals Radiological Classification and Clinical Results of Arthroscopic and Open Surgical Release for Elbow Osteoarthritis: A Two-Center Comparative Case Series

2021 ◽  
Author(s):  
Masahiro Tatebe ◽  
Akimasa Morita ◽  
Toshikazu Kurahashi ◽  
Hitoshi Hirata
Keyword(s):  
Range Of Motion ◽  
Open Surgery ◽  
Arthroscopic Surgery ◽  
Intraclass Correlation ◽  
Case Series ◽  
Clinical Results ◽  
Ectopic Ossification ◽  
Surgery Group ◽  
Elbow Osteoarthritis ◽  
Group A

Abstract Background This study aimed to compare the image classification and clinical results in cases of debridement arthroplasty for elbow osteoarthritis and to compare between open and arthroscopic surgery performed at two independent facilities. Methods Of the 51 patients who underwent surgery for elbow osteoarthritis performed by two doctors, 36 patients whom we were able to observe for more than 6 months were included. One doctor performed open surgery at one hospital, while another doctor performed arthroscopic surgery at the other hospital. There were 15 cases of open surgery (group O) and 21 cases of arthroscopic surgery (group A). All patients were examined for the range of motion, Hand20 score, and pain. The degree of osteoarthritis was examined using the Broberg and Morrey classification and Hastings and Rettig classification. The intra- and interobserver degree of agreement of the two classifications were analyzed using intraclass correlation coefficients.ResultsThe range of motion improved in both groups. There were no significant differences between the two groups with respect to incidence of ulnar symptoms, operation time, postoperative Hand20 score, postoperative pain, and degree of radiological osteoarthritis. The intra- and interobserver degree of agreement for radiological classifications were moderate to substantial and moderate, respectively. There was no correlation between the clinical results and radiological classifications. One patient in group A showed ectopic ossification but no serious complications or adverse events, such as nerve damage, were observed in either group. ConclusionsAt the time of the final follow-up, nearly the same results were observed in both groups. No relationship was found between symptoms and radiological osteoarthritis classification scores. Level of EvidenceTreatment study Level III

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