Application of artificial vertebral body in lesions of thoracic and lumber vertebra / 中国矫形外科杂志

ABSTRACT

[Objective]To observe the clinical results of adjustable hollow titanium artificial vertebra in the treating of tumor,tuberculosis and severe burst fracture of the thoracic and lumber vertebra.[Method]Totally 169 cases of thoracolumbar fractures were treated,including 64 cases of tumor,66 cases of tuberculosis and 39 cases of severe burst fracture of the thoracic and lumber spine,of which 57 cases with kyphosis of those Cobb's angle was 27.1~65.4 degrees with a mean(38.5?10.7)degrees,were treated by one-stage procedure,including pathologic vertebral resection,anterior interbody reduction and implant adjustable hollow titanium artificial vertebral body,anterior internal fixation or posterior transpedicular fixation,reconstruction of spinal stability.For anterior stabilization,the Centaur plate system,Z-plate and XIAⅡrod-screw spinal system were used.Relief of the pain,the function of spinal cord or nerve,kyphosis collection and spinal stability were monitored.[Result]Postoperatively,the period of follow-up lasted 12 months to 46 months with a mean of 32 months.All these patients had their incision healed by first intention,and no recurrence was noted in those patients of tumor and tuberculosis.All patients experienced significant palliation local pain,and 73 patients showed improved neurological status(at least one grade improvement on Frankel's functional classification).The instrumentation provided immediate stability and protected against development of kyphotic deformity in all patients.Postoperative radiological evaluation revealed that implants were stable,there was no phenomena of prosthesis subsidence,hook dislodgment and failure restoration of spinal segments height.Solid bony fusion was obtained in all patients.The residual kyphotic deformity had been corrected by(31.6?8.3)degrees with a mean(6.2?8.7)degrees after operation.[Conclusion]Pathologic vertebral resection,artificial vertebral body replacement and internal fixation are ideal treatmens in thorough decompression,release of pain,reconstruction of spinal stability and resume of spinal sequence.