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Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine

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Abstract

A prospective longitudinal study was performed to evaluate the vertebral body replacement system Synex associated with posterior fixation in unstable burst fractures of the lumbar and thoracic spine. Within 24 months, we treated 28 patients (average age, 41 years; range, 22–64 years; 14 women, 14 men) with acute unstable burst fractures without osteoporosis of the thoracolumbar region (n=16) and the thoracic (n=3) as well as the lumbar (n=9) spine in two stages (primary dorsal transpedicular stabilization and secondary vertebral body replacement). The complications were analyzed and the postoperative follow-up result was evaluated regarding stability, bone fusion, correction loss, pain and neurological status. One patient showed a transient irritation of the lumbosacral plexus and one patient had a superficial wound infection (complication rate, 7.1%). At the follow-up examination (mean follow-up, 13 months) only in two cases a minimal loss of correction (<5°) was measured. Radiologically, 27 patients showed secure bone fusions and all patients had stability of the osteosynthesis. Most of the patients stated no or just slight pain at follow-up. Only two patients with pain to a medium degree had to take painkillers. The vertebral body replacement system Synex seems to be a good alternative for vertebral body replacement in unstable burst fractures of the thoracic and lumbar spine since at present follow-up it shows a high rate of bone fusion and minimal loss of correction.

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References

  1. Been HO (1991) Anterior decompression and stabilization of thoracolumbar burst fractures by the use of the Slot-Zielke device. Spine 16:70–77

    Article  PubMed  CAS  Google Scholar 

  2. Esses SI, Botsford DJ, Kostuik JP (1990) Evaluation of surgical treatment for burst fractures. Spine 15:667–673

    Article  PubMed  CAS  Google Scholar 

  3. Feil J, Wörsdorfer O (1990) Ventral Stabilisation of the thoracic and lumbar spine. Chirurg 63:856–865 (in German)

    Google Scholar 

  4. Fountain S (1979) A single-stage combined surgical approach for vertebral resection. J Bone Joint Surg Am 61:1011–1017

    PubMed  CAS  Google Scholar 

  5. Haas N, Blauth M, Tscherne H (1996) Anterior plating in thoracolumbar spine unstable burst fractures in the absence of neurological deficits. Spine 21:620–625

    Article  Google Scholar 

  6. Kaneda K, Taneichi H, Abumi K, Hashimoto T (1997) Anterior decompression and stabilization with the Kaneda device for thoracolumbar fractures associated with neurological deficits. J Bone Joint Surg Am 79:69–83

    PubMed  CAS  Google Scholar 

  7. McDonough PW, Davis R, Tribus C, Zdelblick TA (2004) The management of acute thoracolumbar burst fractures with anterior corpectomy and Z-plate fixation. Spine 29:1901–1909

    Article  PubMed  Google Scholar 

  8. Miyakoshi N, Abe E, Shimada Y et al (1999) Anterior decompression with single segmental spinal interbody fusion for lumbar burst fracture. Spine 24:67–73

    Article  PubMed  CAS  Google Scholar 

  9. Van Loon JLM, Slot GH, Pavlov PW (1996) Anterior instrumentation of the spine in thoracic and thoracolumbar fractures. Spine 21:734–739

    Article  PubMed  Google Scholar 

  10. Knop C, Lange U, Bastian L, Blauth M (2000) Three-dimensional motion analysis with Synex. Comparative biomechanical test series with a new vertebral body replacement for the thoracolumbar spine. Eur Spine J 9:472–485

    Article  PubMed  CAS  Google Scholar 

  11. Vieweg U, Sölch O, Kalff R (2003) Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine — a retrospective study on 30 cases. Zentralbl Neurochir 64:58–64 (in German)

    Article  PubMed  CAS  Google Scholar 

  12. Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201

    Article  PubMed  CAS  Google Scholar 

  13. Stover LS, Apple DF, Donovan WH, Ditunno JF (1992) Standards for neurological and functional classification of spinal injuries. American Spinal Injury Association (ASIA), New York

    Google Scholar 

  14. Okuyama K, Abe E, Chiba M et al (1996) Outcome of anterior decompression and stabilization for thoracolumbar unstable burst fractures in the absence of neurologic deficits. Spine 21:620–625

    Article  PubMed  CAS  Google Scholar 

  15. Vieweg U, Kaden B, Schramm J (1996) Vertebral body replacement with a rib segment bloc in transthoracic procedures. Zentralbl Neurochir 57:136–142 (in German)

    PubMed  CAS  Google Scholar 

  16. Downie WW, Leatham PLA, Rhind VM, Wright V (1978) Studies with pain rating scales. Ann Rheum Dis 37:378–381

    Article  PubMed  CAS  Google Scholar 

  17. Harrington KD (1981) The use of methylmethacrylate for vertebral body replacement and anterior stabilization of pathological fracture dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg Am 63:36–46

    PubMed  CAS  Google Scholar 

  18. Knop C, Bastian L, Lange et al (2002) Complications in surgical treatment of thoracolumbar injuries. Eur Spine J 11:214–226

    Article  PubMed  CAS  Google Scholar 

  19. McAfee PC (1991) Interbody fusion cages in reconstructive operations on the spine. J Bone Joint Surg Am 81:190–191

    Google Scholar 

  20. Polster J, Brinkmann P (1977) A vertebral body implant for use in palliative surgery of spinal tumors. Z Orthop 115:118–122 (in German)

    PubMed  CAS  Google Scholar 

  21. Plötz W, Wicke-Wittenius S, Göbel WE et al (1995) Vertebral body replacement in palliative tumor treatment. Fortschr Med 113:437–440 (in German)

    PubMed  Google Scholar 

  22. Rauzzino M, Shaffrey CI, Nockels RP et al (1999) Anterior lumbar fusion with titanium threated and interbody cages. Neurosurg Focus 7:article 7

  23. McLain RF, Benson DR, Gertzbein GD (1999) Urgent surgical stabilization of spinal fractures in polytrauma patients. Spine 24:1646–1652

    Article  PubMed  CAS  Google Scholar 

  24. Kanziora F, Schnake KJ, Klostermann CK, Hass NP (2004) Vertebral body replacement in spine surgery. Unfallchirurg 107:354–371 (in German)

    Google Scholar 

  25. Thomsen K, Christensen FB, Eiskjaer SP et al (1999) The effect of pedicle screw instrumentation on functional outcome and fusion rates in posterolateral lumbar spinal fusion: a prospective, randomized clinical study. Spine 22:2813–2822

    Article  Google Scholar 

  26. Aebi M, Etter C, Kehl T, Thalgott J (1987) Stabilization of the lower thoracic and lumbar spine with the internal spinal skeletal fixation system. Indications, techniques and first results of treatment. Spine 12:544–555

    Article  PubMed  CAS  Google Scholar 

  27. Knop C, Blauth M, Bastian L et al (1997) Fractures of the thoracolumbar spine. Late results of dorsal instrumentation and its consequences. Unfallchirurg 100:630–639 (in German)

    Article  PubMed  CAS  Google Scholar 

  28. Leferink VJM, Zimmerman KW, Veldhuis EFM et al (2001) Thoracolumbar spinal fractures — radiological results of transpedicular fixation combined with transpedicular cancellous bone graft and posterior fusion in 183 patients. Eur Spine J 10:517–523

    Article  PubMed  CAS  Google Scholar 

  29. Feil J, Wörsdorfer O (1992) Complications in surgical management of spinal injuries. Langenbecks Arch Chir Suppl Kongressbd 87:304–310 (in German)

    Google Scholar 

  30. McAfee PC, Bohlmann HH, Ducker T, Eismont FJ (1986) Failure of stabilization of the spine with methylmethacrylate — Aretrospective analysis of twenty-four cases. J Bone Joint Surg Am 68:1145–1157

    PubMed  CAS  Google Scholar 

  31. Bhat AL, Lowery GL, Sei A (1999) The use of titanium surgical mesh-bone graft composite in the anterior thoracic or lumbar spine after complete or partial corpectomy. Eur Spine J 8:304–309

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Spine Surgery, Leopoldina Hospital Schweinfurt, Gustav-Adolf-Street 8, D-97422, Schweinfurt, Germany

    U. Vieweg

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  1. U. Vieweg
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Vieweg, U. Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine. J Orthopaed Traumatol 8, 64–70 (2007). https://doi.org/10.1007/s10195-007-0166-9

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  • DOI: https://doi.org/10.1007/s10195-007-0166-9

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