Dvorak Marcel F, Kwon Brian K, Fisher Charles G, Eiserloh Henry L, Boyd Michael, Wing Peter C
Division of Spine, Department of Orthopaedics, University of British Columbia, Canada.
Spine (Phila Pa 1976). 2003 May 1;28(9):902-8. doi: 10.1097/01.BRS.0000058712.88053.13.
A retrospective cohort study with cross-sectional outcome analysis of patients who underwent anterior column reconstruction with a titanium mesh cage after single-level or multilevel thoracic or lumbar vertebrectomy.
To radiographically evaluate the ability of titanium mesh cages to maintain alignment and facilitate osseous fusion after thoracolumbar vertebrectomy. Secondary objectives assessed complications and patient outcome.
Titanium mesh cages with cancellous autograft bone for postvertebrectomy reconstruction of the thoracolumbar spine avoid some of the potential problems associated with the acquisition or use of structural autograft or allograft. There is little in the literature that describes the efficacy or outcomes of using cylindrical mesh titanium cages for postvertebrectomy reconstruction.
The degree of kyphosis and the subsidence of the cage in relation to the vertebral endplates were measured in 43 of 57 (75%) patients available at a minimum of 2 years following titanium mesh cage reconstruction. Health-related quality of life and disability were assessed with various cross-sectional outcome measures.
The average kyphosis of 25.4 degrees before surgery was reduced to 7.5 degrees immediately after surgery, and at final follow-up was measured to be 10.4 degrees. Cage subsidence averaged 0.28 and 0.20 cage fenestrations at the cephalad and caudal endplates, respectively. Osseous union (Grade 1 or 2) was identified in 93% of radiographs at the final follow-up. Thoracic reconstructions were significantly more likely to require surgical revision because of mechanical failure than thoracolumbar or lumbar reconstructions.
The cylindrical mesh titanium cage is a successful adjunct in restoring and maintaining sagittal plane alignment after thoracolumbar vertebrectomy and, in this context, provides an effective method for anterior column reconstruction.
一项回顾性队列研究，对单节段或多节段胸腰椎椎体切除术后使用钛网笼进行前柱重建的患者进行横断面结果分析。
通过影像学评估钛网笼在胸腰椎椎体切除术后维持脊柱对线并促进骨融合的能力。次要目的是评估并发症和患者预后。
用于胸腰椎椎体切除术后重建的带松质骨自体移植骨的钛网笼避免了与获取或使用结构性自体移植骨或同种异体移植骨相关的一些潜在问题。文献中很少描述使用圆柱形网状钛笼进行椎体切除术后重建的疗效或结果。
在57例患者中的43例（75%）中，测量了钛网笼重建后至少2年时与椎体终板相关的后凸程度和笼体沉降情况。使用各种横断面结果指标评估与健康相关的生活质量和残疾情况。
术前平均后凸25.4度，术后立即降至7.5度，末次随访时为10.4度。笼体在头侧和尾侧终板的沉降平均分别为0.28和0.20个笼孔。末次随访时，93%的X线片显示骨融合（1级或2级）。与胸腰段或腰段重建相比，胸段重建因机械故障而需要手术翻修的可能性显著更高。
圆柱形网状钛笼是胸腰椎椎体切除术后恢复和维持矢状面脊柱对线的成功辅助工具，在此背景下，为前柱重建提供了一种有效的方法。
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