Biomechanical analysis of a new expandable vertebral body replacement combined with a new polyaxial antero-lateral plate and/or pedicle screws and rods

Ulmar, Benjamin; Erhart, Stefanie; Unger, Stefan; Weise, K.; Schmoelz, Werner

doi:10.1007/s00586-011-2042-9

Cited by 13 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Flexion-extension ROM was reduced for the posterior system. Ulmar et al 37 measured similar lateral bending stability between a fixed-angle screw anterior plate system and posterior pedicle screws. In flexion-extension and axial rotation, the posterior fixation was more rigid than the anterior plate.…”

Section: Discussionmentioning

confidence: 93%

Contribution of Round vs. Rectangular Expandable Cage Endcaps to Spinal Stability in a Cadaveric Corpectomy Model

et al. 2015

View full text Add to dashboard Cite

BackgroundExpandable cages are gaining popularity in anterior reconstruction of the thoracolumbar spine following corpectomy as they can provide adjustable distraction and deformity correction. Rectangular, rather than circular, endcaps provide increased resistance to subsidence by spanning the apophyseal ring; however their impact on construct stability is not known. The objective of this study was to investigate the contribution of expandable corpectomy cage endcap shape (round vs. rectangular) and fixation method (anterior plate vs. posterior pedicle screws) to the stability of an L1 sub-total corpectomy construct.

show abstract

Section: Discussionmentioning

confidence: 93%

Contribution of Round vs. Rectangular Expandable Cage Endcaps to Spinal Stability in a Cadaveric Corpectomy Model

et al. 2015

View full text Add to dashboard Cite

show abstract

“…There is evidence that anteroposterior treatment provides the most stable biomechanical solution for thoracolumbar vertebral traumas. 3,11,19,25,26,36 In our study, an expandable titanium corpectomy cage was used for anterior column reconstruction following posterior reduction and stabilization. The cage was used to stabilize the anterior column but not for reduction, since anatomical reduction is difficult to achieve from an anterior approach and immediate cage subsidence may occur.…”

mentioning

confidence: 99%

Five-year clinical and radiological results of combined anteroposterior stabilization of thoracolumbar fractures

Schnake¹,

Stavridis²,

Kandziora³

2014

SPI

View full text Add to dashboard Cite

Object Despite promising early clinical results, the long-term outcome of the use of expandable titanium cages to reconstruct the anterior column after traumatic burst fractures is still unknown. The purpose of this prospective study was to assess the clinical and radiological outcomes of the use of expandable titanium cages 5 years postoperatively. Methods Eighty patients with traumatic thoracolumbar burst fractures (T4–L5) underwent posterior stabilization followed by anterior corpectomy and reconstruction using expandable titanium cages with or without additional anterior plating. After 5 years, fusion was evaluated by means of plain radiographs and CT scans, and the patients' scores on the Oswestry Disability Index (ODI), their neurological status, and clinical results were assessed. Results Forty-five (56%) of the 80 patients could be examined after 5 years. There was a relatively high rate of complications related to thoracotomy (26%), but there were no complications directly related to the cages. Revision surgery was required in 1 case. The average postoperative loss of correction was only 2.4° due to minimal subsidence of the cages. No cage showed a radiolucent line or instability in flexion-extension views. Bony fusion, as assessed by CT scan, was achieved in 41 patients (91%). On clinical examination, 96% of all patients were ambulatory and showed minimal restriction of spinal range of motion; 71% did not need analgesic medication at all; and 67% were able to work. The average ODI score was 12. Thirty-one percent of patients complained of some kind of anterior approach–related complications. Conclusions Combined anteroposterior stabilization of thoracolumbar burst fractures with expandable titanium cages is a relative safe procedure with satisfactory radiological and clinical long-term outcome. High fusion rates can be achieved, with only minor loss of correction, typically occurring in the 1st year. However, open thoracotomy carries the risks of additional complications and development of post-thoracotomy syndrome.

show abstract

“…Vertebral body replacement (VBR) combined with dorsal instrumentation is the preferred treatment option to achieve decompression and restore stability of the spinal column either in patients with a traumatic fracture (>AO Spine A3) [1,2,3,4,5,6] or major pathological instability due to infection [7,8,9,10], spinal metastases [11,12,13] or primary malignancy [7,8,11,12,13]. Metastatic spinal lesions occur in 5%–10% of all cancer patients while primary spinal tumors are a rare entity [12].…”

Section: Introductionmentioning

confidence: 99%

“…Metastatic spinal lesions occur in 5%–10% of all cancer patients while primary spinal tumors are a rare entity [12]. Most spinal metastases are located anteriorly in the vertebral body and in the peridural space, while a dorsal location is rare [4,6,10,11,12,14]. The incidence of clinically apparent metastatic disease in the spine has increased since advances in tumor treatment generally have improved the life expectancy of cancer patients [10,15].…”

Section: Introductionmentioning

confidence: 99%

“…However, more radical treatment options with removal of spinal lesions showed better results in patients with good prognosis [17,18,19,20]. A loss of correction [4,7,8] or implant failures due to loosening at the implant–bone interface with recurrent instability [1,9,10,13,16] are well described after isolated posterior instrumentation. 360° instrumentations provide the highest stiffness in biomechanical studies, where a rotationally unstable corpectomy defect model is used [4,6,7,10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical Study of a Novel, Expandable, Non-Metallic and Radiolucent CF/PEEK Vertebral Body Replacement (VBR)

et al. 2019

Self Cite

View full text Add to dashboard Cite

Vertebral body replacement is well-established to stabilize vertebral injuries due to trauma or cancer. Spinal implants are mainly manufactured by metallic alloys; which leads to artifacts in radiological diagnostics; as well as in radiotherapy. The purpose of this study was to evaluate the biomechanical data of a novel carbon fiber reinforced polyetheretherketone (CF/PEEK) vertebral body replacement (VBR). Six thoracolumbar specimens were tested in a six degrees of freedom spine tester. In all tested specimens CF/PEEK pedicle screws were used. Two different rods (CF/PEEK versus titanium) with/without cross connectors and two different VBRs (CF/PEEK prototype versus titanium) were tested. In lateral bending and flexion/extension; range of motion (ROM) was significantly reduced in all instrumented states. In axial rotation; the CF/PEEK combination (rods and VBR) resulted in the highest ROM; whereas titanium rods with titanium VBR resulted in the lowest ROM. Two cross connectors reduced ROM in axial rotation for all instrumentations independently of VBR or rod material. All instrumented states in all planes of motion showed a significantly reduced ROM. No significant differences were detected between the VBR materials in all planes of motion. Less rigid CF/PEEK rods in combination with the CF/PEEK VBR without cross connectors showed the smallest reduction in ROM. Independently of VBR and rod material; two cross connectors significantly reduced ROM in axial rotation. Compared to titanium rods; the use of CF/PEEK rods results in higher ROM. The stiffness of rod material has more influence on the ROM than the stiffness of VBR material.

show abstract

Biomechanical analysis of a new expandable vertebral body replacement combined with a new polyaxial antero-lateral plate and/or pedicle screws and rods

Cited by 13 publications

References 34 publications

Contribution of Round vs. Rectangular Expandable Cage Endcaps to Spinal Stability in a Cadaveric Corpectomy Model

Contribution of Round vs. Rectangular Expandable Cage Endcaps to Spinal Stability in a Cadaveric Corpectomy Model

Five-year clinical and radiological results of combined anteroposterior stabilization of thoracolumbar fractures

Biomechanical Study of a Novel, Expandable, Non-Metallic and Radiolucent CF/PEEK Vertebral Body Replacement (VBR)

Contact Info

Product

Resources

About