Abstract
We studied prospectively the clinical and radiological course of 36 patients with localised spinal instability treated with vertebrectomy. A distractible titanium cage filled with polymethylmethacrylate (PMMA) in combination with transpedicular fixation was used to restore spinal stability. Mean follow-up was 16 (8–55) months. Average correction of the segmental kyphosis was 15.2° (−2–29°). During follow-up, a loss of correction of 0.9° (−2–15°) was seen. Segmental height was increased by 7.6 (0–14) mm on average with a mean loss of 1.6 (0–2) mm. Twenty-one patients without pre-operative neurological deficits were ambulatory without orthosis at discharge. Patients presenting with neurological deficits were unchanged (n=3) or improved (n=12).
Résumé
Nous avons étudié prospectivement l’évolution clinique et radiologique de 36 malades avec une instabilité vertébrale localisée traitée par vertebrectomie. Une cage en titane distractable remplie de PMMA en combinaison avec une fixation transpédiculaire a été utilisée pour restaurer la stabilité vertébrale. Le suivi moyen était de 16 mois (8–55). La correction moyenne de la cyphose segmentaire était de 15,2° (−2–29°). Pendant le suivi une perte de correction de 0,9° (−2–15°) a été notée. La hauteur segmentaire a été augmentée à 7,6 (0–14) mm en moyenne avec une perte moyenne de 1,6 (0–2) mm. Vingt et un malades sans déficit neurologique préopératoire pouvaient marcher sans orthèse. Les malades qui présentaient un déficit neurologique étaient inchangés (n=3) ou améliorés (n=12).
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Kluba, T., Giehl, J.P. Distractible vertebral body replacement in patients with malignant vertebral destruction or osteoporotic burst fractures. International Orthopaedics (SICOT) 28, 106–109 (2004). https://doi.org/10.1007/s00264-003-0518-x
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DOI: https://doi.org/10.1007/s00264-003-0518-x