Anterior vertebral body replacement with a titanium implant of adjustable height: a prospective clinical study |
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Authors: | Uta Lange Sebastian Edeling Christian Knop Leonard Bastian Michael Oeser Christian Krettek Michael Blauth |
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Institution: | (1) Trauma Department, Hannover Medical School, Hannover, Germany;(2) Department of Trauma Surgery and Sport Traumatology, Leopold Franzens University, Innsbruck, Austria |
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Abstract: | In the operative treatment of spinal injuries, the reconstruction of the anterior column of the thoracolumbar spine is still
controversial. We conducted a prospective clinical study to investigate the clinical and radiological outcome of 50 patients
treated with a vertebral body replacement of adjustable height (Synex™). Fifty consecutive patients were evaluated during
in-patient treatment and at 12 and 20 months post-operatively in clinical notes and radiographs. 38/50 patients were operated
for traumatic fractures. Out of 50 patients 45 attended the follow-up clinic 1 year post-operatively and 39 of these patients
were examined after 20 months. Twenty-five patients returned to pre-injury activities within 1 year. This number increased
to 29/39 patients at 20 months. Seventy-three percent of the patients returned to their job. After 1 year 25/45 patients complained
of little or no back pain and 6 months later six patients were limited in their back function. At 1 year only three patients
complained of surgical site pain which was improved at their final follow-up at 20 months. Individual satisfaction was determined
using a score on a visual analog scale containing 19 questions on back pain, and functional limitation of the spine that has
to be filled in by the patients at three different points of time. The score decreased from 87/100 pre-operatively to 65/100
at 1 year follow-up (P<0.001). The average permanent correction of the injured vertebra was 16.8° (88%) including 2.3° (12%) loss of correction
at 12 months after operation. Bony integration was obtained in 83%. Early and intermediate outcome with the Synex™ vertebral
replacement device for reconstruction of the anterior column appears promising. The loss of correction or reduction was only
minimal. On the basis of our results we recommend the Synex™ implant as an alternative for the fixation and stabilisation
of thoracolumbar fractures. However, long-term results and a clinically random control study are still required. |
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Keywords: | Thoracolumbar spine Spinal injuries Vertebral body replacement Spinal fixation Stability |
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