The use of titanium surgical mesh-bone graft composite in the anterior thoracic or lumbar spine after complete or partial corpectomy

Abstract

Various conditions such as fracture, dislocation, tumor, or infection adversely affect the vertebral body and lead to instability. Restoration of a stable anterior column is essential for normal spinal biomechanics. Various biological and mechanical spacers have been used to reconstruct the anterior column after corpectomy. In this retrospective review, the authors evaluated clinical charts and radiographs of 13 patients receiving titanium surgical mesh (TSM)-bone graft composite to reconstruct the anterior spinal column in the thoracic or lumbar region. The objective of this review was to evaluate the stability and efficacy of the TSM-bone graft composite in the anterior spine after a complete or partial corpectomy. Sixteen patients with involvement of the thoracic or lumbar vertebral column after trauma, tumor, or infection underwent partial or complete corpectomy. In all patients the anterior defect was reconstructed using a TSM-bone graft composite. Three patients died within 12 months postoperatively due to primary malignant process. Thirteen of 16 patient charts and radiographs were evaluated for anterior fusion status, settling of the TSM-bone graft composite, and hardware failure. No pseudoarthroses were noted. Evidence of solid anterior fusion was noted in all patients. The average settling of the TSM-bone graft construct was 3 mm. All patients presenting with only pain and no neurological symptoms (n = 9) experienced early pain relief. For patients presenting with neurological symptoms (n = 4), the recovery was complete in three and partial in one. No patient was made neurologically worse, and there were no vascular injuries intra- or postoperatively. The study suggests that TSM-bone graft composite offers excellent biomechanical stability in the immediate postoperative period, permitting progressive maturation of the fusion mass.