Vertebral Body Replacement

  • Jürgen Nothwang


The anterior support in thoracolumbar spine fractures and in some special cases of tumour diseases is one of the most important steps for reconstructing the shape of the vertebral column to preserve satisfying long-term results. A lot of biomechanical and clinical investigations confirm the necessity of anterior reconstruction in bisegmental posterior stabilizations to avoid posterior implant failure. Potential of healing of a bisegmental corticocancellous graft is limited. With vertebral body replacements (VBR), the loss of correction after removal of the posterior stabilization device is small. VBRs with expandable components (see Fig. 33.1) allow an adapted anterior defect bridging and open the possibility of anterior reduction.


Vertebral Body Endoscopic Technique Endoscopic Approach Cement Augmentation Adjacent Vertebral Body 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



American Society of Anesthesiologists


Functional spine unit


Magnetic resonance imaging


New York Heart Association


Vertebral body replacement


  1. 1.
    Beisse R (2005) Complications of endoscopic surgery of the spine. Trauma Berufskrankh 7(Suppl 2):321–326CrossRefGoogle Scholar
  2. 2.
    Cripton PA, Jain GM, Wittenberg RH et al (2000) Load sharing characteristics of stabilized lumbar spine segment. Spine 25:170–179PubMedCrossRefGoogle Scholar
  3. 3.
    Cunningham BW, Sefter JC, Shono Y (1993) Static and cyclic biomechanical analysis of pedicle screw spinal constructs. Spine 18:1677–1688PubMedCrossRefGoogle Scholar
  4. 4.
    Knop C, Blauth M, Bühren V et al (2001) Operative treatment of thoracolumbar fractures – results of a prospective multicenter study by the working group “spine” of the German Society of Trauma Surgery Part 3 Follow-up. Unfallchirurg 104:583–600PubMedCrossRefGoogle Scholar
  5. 5.
    Maiman DJ, Pintar F, Yoganandan N et al (1993) Effects of anterior vertebral grafting on the traumatized lumbar spine after pedicle screw-plate fixation. Spine 18:2423–2430PubMedCrossRefGoogle Scholar
  6. 6.
    Matschke S, Wagner C, Davids D et al (2006) Complications in endoscopic anterior thoracolumbar spinal reconstructive surgery. Eur J Trauma 23:215–226CrossRefGoogle Scholar
  7. 7.
    McLain RF, Sparling D, Benson DR (1993) Early failure of short segment pedicle instrumentation for thoraco-lumbar fractures. A preliminary report. J Bone Joint Surg Am 75:162–167PubMedGoogle Scholar
  8. 8.
    Nothwang J, Ulrich C (2000) The reconstruction of the anterior ­column of thoracolumbar spine fractures. Osteosynthese Int 8:1–6Google Scholar
  9. 9.
    Rohlmann A, Graichen F, Bender A et al (2008) Loads on a telemeterized vertebral body replacement measured in three patients within the first postoperative month. Clin Biomech 23:147–158CrossRefGoogle Scholar
  10. 10.
    Sasso RC, Cottler HB (1993) Posterior instrumentation and fusion for unstable fractures and fracture dislocations of the thoracic and lumbar spine. Spine 18:450–560PubMedGoogle Scholar
  11. 11.
    Reinhold M, Schmölz W, Canto F et al (2007) An improved vertebral body replacement for the thoracolumbar spine. A biomechanical in vitro test on human lumbar vertebral bodies. Unfallchirurg 110(4):327–333PubMedCrossRefGoogle Scholar
  12. 12.
    Taneichi H, Kaneda K, Takeda N et al (1997) Risk factors and probability of vertebral body collapse in metastases of the thoracic and lumbar spine. Spine 22:239–245PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Traumatology and OrthopedicsRems-Murr-Kliniken gGmbHSchondorfGermany

Personalised recommendations