Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages

Abstract

The purpose of this study was to investigate the outcome of expandable titanium cage implantation in large defects caused by acute vertebral osteomyelitis. Twenty-five patients with acute single or multilevel spondylodiscitis were treated after radical débridement and posterior instrumentation with an anterior expandable titanium cage and bone grafting. Clinical, laboratory and radiological follow-up continued for 36 months. Within the postoperative course there was no recurrence of spinal infection. The final radiological examination showed successful fusion in all cases without implant loosening or failure. At the final follow-up after 36 months the Oswestry Disability Index was 23 +/- 14 and the pain visual analogue scale 2.1 +/- 1.7. This study reveals healing and improved function after expandable titanium cage implantation in all patients. Prerequisites for optimal healing include radical débridement, provision of stability for weight-bearing, adequate bone grafting and correction of deformity using rigid implants.

Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases

“…Titanium has been successfully proven to provide sufficient resistance to microbial adherence and showed good radiological results in pyogenic spondylodiscitis [18,19]. Poly-ether-ether-ketone (PEEK) cages as biocompatible alternatives to titanium implants have been used in spinal fusion surgery, but still have been an issue of debate in pyogenic spondylodiscitis.…”

Successful treatment of spondylodiscitis using titanium cages: A 3-year follow-up of 22 consecutive patients

“…Several authors have recently presented favorable results regarding healing and avoidance or correction of deformity using titanium implants (Heyde et al 2006, Kuklo et al 2006, Ruf et al 2007. In large anterior defects after severe spondylitis, the use of anterior titanium cages is especially advantagious in reconstruction of the sagittal alignment (Robinson et al 2008).…”

Failure of an expandable cage-plate cervical vertebral body replacement: case report of a device related complication

“…[1][2][3][4][5] A new advanced method is use of expandable titanium cages which allow easy replacement with in situ expansion and reproduction of the sagittal profile. [9][10][11][12][13] Stabilization can be achieved by additional anterior plating or posterior stabilization by a rod and screw system.…”

“…[1][2][3][4][5] Expandable and non-expandable cages have gained acceptance for replacement of the vertebral body. Stabilization can be achieved by additional anterior plating or posterior stabilization by a rod and screw system.…”