Anterior Column Reconstruction of Destructive Vertebral Osteomyelitis at the Thoracolumbar Spine with an Expandable Vertebral Body Replacement Implant: A Retrospective, Monocentric Radiological Cohort Analysis of 24 Cases

URN to cite this document:

urn:nbn:de:bvb:355-epub-554654 Copy

DOI to cite this document:

10.5283/epub.55465 Copy

Klute, Lisa ; Esser, Marie ; Henssler, Leopold ; Riedl, Moritz ; Schindler, Melanie ; Rupp, Markus ; Alt, Volker ; Kerschbaum, Maximilian ; Lang, Siegmund

License: Creative Commons Attribution 4.0 PDF - Published Version (1MB)

Date of publication of this fulltext: 29 Jan 2024 10:29

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Alternative links to fulltext:DOIPublisher

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Details

Item type:	Article
Open Access Type:	Gold (with APC)
Journal or Publication Title:	Journal of Clinical Medicine
Publisher:	MDPI
Volume:	13
Number of Issue or Book Chapter:	1
Page Range:	p. 296
Date:	4 January 2024
Institutions:	Medicine > Lehrstuhl für Unfallchirurgie
Identification Number:	Value Type 10.3390/jcm13010296 DOI
Keywords:	expandable vertebral body replacement; vertebral osteomyelitis; bony fusion rate; anterior column reconstruction; spondylodiscitis
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	55465

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Abstract

Background: Vertebral osteomyelitis (VO) often necessitates surgical intervention due to bone loss-induced spinal instability. Anterior column reconstruction, utilizing expandable vertebral body replacement (VBR) implants, is a recognized approach to restore stability and prevent neurological compromise. Despite various techniques, clinical evidence regarding the safety and efficacy of these ...

Abstract

Background: Vertebral osteomyelitis (VO) often necessitates surgical intervention due to bone loss-induced spinal instability. Anterior column reconstruction, utilizing expandable vertebral body replacement (VBR) implants, is a recognized approach to restore stability and prevent neurological compromise. Despite various techniques, clinical evidence regarding the safety and efficacy of these implants in VO remains limited. Methods: A retrospective cohort analysis, spanning 2000 to 2020, was conducted on 24 destructive VO cases at a Level 1 orthopedic trauma center. Diagnosis relied on clinical, radiological, and microbiological criteria. Patient demographics, clinical presentation, surgical interventions, and radiological outcomes were assessed. Results: The study included 24 patients (62.5% male; mean age 65.6 ± 35.0 years), with 58% having healthcare-associated infections (HAVO). The mean radiological follow-up was 137.2 ± 161.7 weeks. Surgical intervention significantly improved the bi-segmental kyphotic endplate angle (BKA) postoperatively (mean −1.4° ± 13.6°). However, a noticeable loss of correction was observed over time. The study reported a mortality rate of 1/24. Conclusions: Anterior column reconstruction using expandable VBR effectively improved local spinal alignment in destructive VO. However, the study underscores the necessity for prolonged follow-up and continuous research to refine surgical techniques and postoperative care. Addressing long-term complications and refining surgical approaches will be pivotal as the field progresses.

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Metadata last modified: 15 Jul 2024 15:04

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