Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model

Introduction. Vertebral compression fractures (VCFs) affect 20% of people over the age of 70 with increasing incidence. Kypho-/vertebroplasty as standard operative procedures are associated with limitations like cement leakage, limited reduction capabilities, and risk for adjacent fractures. To address these shortcomings, we introduce a new minimal invasive cementless VCF fixation technique.Methods. Four patients (72.3 years, range 70–76) with VCFs type AO/Müller A1.3 and concomitant osteoporosis were treated by minimal invasive transpedicular placement of two intervertebral mesh cages for fracture reduction and maintenance. Follow-up included functional/radiological assessment and clinical scores and averaged 27.7 months (24–28).Results. Endplate reduction was achieved in all cases (mean surgery time: 28.5 minutes). Kyphotic (KA) and Cobb angle revealed considerable improvements postoperatively (KA 14.5° to 10.7°/Cobb 10.1° to 8.3°). Slight loss of vertebral reduction (KA: 12.6°) and segment rekyphosis (Cobb: 10.7°) were observed for final follow-up. Pain improved from 8.8 to 2.8 (visual analogue scale). All cases showed signs of bony healing. No perioperative complications and no adjacent fractures occurred.Conclusion. Preliminary results in a small, selected patient collective indicate the ability of bony healing for osteoporotic VCFs. Cementless fixation using intravertebral titanium mesh cages revealed substantial pain relief, adequate reduction, and reduction maintenance without complications. Trial registration number is DRKS00005657, German Clinical Trials Register (DKRS).

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Analysis of microscopic bone properties in an osteoporotic sheep model: a combined biomechanics, FE and ToF-SIMS study

Journal of The Royal Society Interface ◽

10.1098/rsif.2018.0793 ◽

2019 ◽

Vol 16 (151) ◽

pp. 20180793 ◽

Cited By ~ 3

Author(s):

R. Müller ◽

A. Henss ◽

M. Kampschulte ◽

M. Rohnke ◽

A. C. Langheinrich ◽

...

Keyword(s):

Biomechanical Testing ◽

Tissue Level ◽

Osteoporotic Bone ◽

Compression Tests ◽

Micro Computed Tomography ◽

Deficient Diet ◽

Element Analysis ◽

Sheep Model ◽

Tissue Properties ◽

Bone Properties

The present study deals with the characterization of bone quality in a sheep model of postmenopausal osteoporosis. Sheep were sham operated ( n = 7), ovariectomized ( n = 6), ovariectomized and treated with deficient diet ( n = 8) or ovariectomized, treated with deficient diet and glucocorticoid injections ( n = 7). The focus of the study is on the microscopic properties at tissue level. Microscopic mechanical properties of osteoporotic bone were evaluated by a combination of biomechanical testing and mathematical modelling. Sample stiffness and strength were determined by compression tests and finite-element analysis of stress states was conducted. From this, an averaged microscopic Young’s modulus at tissue level was determined. Trabecular structure as well as mineral and collagen distribution in samples of sheep vertebrae were analysed by micro-computed tomography and time-of-flight secondary ion mass spectrometry. In the osteoporotic sheep model, a disturbed fibril structure in the triple treated group was observed, but bone loss only occurred in form of reduced trabecular number and thickness and cortical decline, while quality of the residual bone was preserved. The preserved bone tissue properties in the osteoporotic sheep model allowed for an estimation of bone strength which behaves similar to the human case.

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Anterior D-rod and titanium mesh fixation for acute mid-lumbar burst fracture with incomplete neurologic deficits A prospective study of 56 consecutive patients

Indian Journal of Orthopaedics ◽

10.4103/0019-5413.159680 ◽

2015 ◽

Vol 49 (4) ◽

pp. 471 ◽

Cited By ~ 1

Author(s):

Zhen-qi Ding ◽

Hao-yuan Liu ◽

Jun Fang ◽

Hui Liu ◽

Mo Sha ◽

...

Keyword(s):

Prospective Study ◽

Mesh Fixation ◽

Burst Fracture ◽

Titanium Mesh ◽

Neurologic Deficits ◽

A Prospective Study

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An Evaluation of Fracture Stabilization Comparing Kyphoplasty and Titanium Mesh Repair Techniques for Vertebral Compression Fractures

Spine ◽

10.1097/brs.0b013e3181d260bf ◽

2010 ◽

Vol 35 (16) ◽

pp. E768-E773 ◽

Cited By ~ 13

Author(s):

Hossein Ghofrani ◽

Thomas Nunn ◽

Claire Robertson ◽

Andrew Mahar ◽

Yupo Lee ◽

...

Keyword(s):

Mesh Repair ◽

Vertebral Compression Fractures ◽

Titanium Mesh ◽

Compression Fractures ◽

Fracture Stabilization ◽

Repair Techniques

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Biomechanical Comparison of Kyphoplasty Versus a Titanium Mesh Implant With Cement for Stabilization of Vertebral Compression Fractures

Spine ◽

10.1097/brs.0b013e3181b7cc5d ◽

2010 ◽

Vol 35 (19) ◽

pp. 1783-1788 ◽

Cited By ~ 21

Author(s):

Vidyadhar V. Upasani ◽

Claire Robertson ◽

Deborah Lee ◽

Tucker Tomlinson ◽

Andrew T. Mahar

Keyword(s):

Vertebral Compression Fractures ◽

Titanium Mesh ◽

Compression Fractures ◽

Mesh Implant ◽

Biomechanical Comparison

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Management of orbital fractures in adolescents. Review and case report of three different techniques

Research Society and Development ◽

10.33448/rsd-v10i6.15335 ◽

2021 ◽

Vol 10 (6) ◽

pp. e23410615335

Author(s):

Bruna da Fonseca Wastner ◽

William Phillip Pereira da Silva ◽

Veridiane Walter Luscinski Dissenha ◽

Mara Albonei Dudeque Pianovski ◽

Leonardo Faverani ◽

...

Keyword(s):

Case Report ◽

Maxillary Sinus ◽

Mesh Fixation ◽

Complete Removal ◽

Anterior Wall ◽

Professional Experience ◽

Orbital Fractures ◽

Titanium Mesh ◽

Fractures In Children ◽

Functional Problems

The management of orbital fractures in children and adolescents is little reported in the literature, considering that orbital fractures can cause functional problems such as enophthalmia, diplopia and aesthetic deformities. The aim of this study is to review the literature and report three clinical cases, corroborating with professional experience, about the different management of orbital fractures in adolescents, approaching the advantages, disadvantages and complications. Among the different fractures of the orbital floor, the techniques of interposition of autograft of the anterior wall of the maxillary sinus, suture for anchoring the periosteum, and reduction and stabilization of the fracture by means of titanium mesh fixation were performed. The choice of material and technique depends on the surgeon's preference, access and availability of materials. Regardless of which technique and material is used, and complete removal of the herniated tissue is fundamental to obtain satisfactory results.

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A preliminary multicenter evaluation of endoscopic sublay repair for ventral hernia from China

10.21203/rs.3.rs-41632/v2 ◽

2020 ◽

Author(s):

Rui Tang ◽

Huiyong Jiang ◽

Weidong WU ◽

Tao Wang ◽

Mengxiang Meng ◽

...

Keyword(s):

Ventral Hernia ◽

Intraoperative Complications ◽

Mesh Fixation ◽

Transversus Abdominis ◽

Intraperitoneal Onlay Mesh ◽

Patient Demographics ◽

Onlay Mesh ◽

Sublay Repair ◽

Space Separation ◽

Ventral Hernias

Abstract Background: For ventral hernia, endoscopic sublay repair (ESR) may overcome the disadvantages of open sublay and laparoscopic intraperitoneal onlay mesh repair. This retrospective study presents the preliminary multicenter results of ESR from China. The feasibility, safety, and effectiveness of ESR were evaluated; its surgical points and indications were summarized. Methods: The study reviewed 156 ventral hernia patients planned to perform with ESR in ten hospitals between March 2016 and July 2019. Patient demographics, hernia characteristics, operative variables, and surgical results were recorded and analyzed.Results: ESR was performed successfully in 153 patients, 135 with totally extraperitoneal sublay (TES) and 18 with transabdominal sublay (TAS). In 19 patients, TES was performed with the total visceral sac separation (TVS) technique, in which the space separation is carried out along the peritoneum, avoiding damage to the aponeurotic structure. Endoscopic transversus abdominis release (eTAR) was required in 17.0% of patients, and only 18.3% of patients required permanent mesh fixation. The median operative time was 135 min. Most patients had mild pain and resume eating soon after operation. No severe intraoperative complications occurred. Bleeding in the extraperitoneal space occurred in two patients and was stopped by nonsurgical treatment. Seroma and chronic pain were observed in 5.23% and 3.07% of patients. One recurrence occurred after TAS repair for an umbilical hernia.Conclusion: ESR is feasible, safe, and effective for treating ventral hernias when surgeons get the relevant surgical skills, such as the technique of “partition breaking,” TVS, and eTAR. Small-to-medium ventral hernias are the major indications.

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Mid-term results of an anterior plating via combined anterior approach for complex acetabular fractures: a retrospective cohort study

10.21203/rs.3.rs-40685/v1 ◽

2020 ◽

Author(s):

Weikun Meng ◽

Yi Ou ◽

Zhaoxiang Wu ◽

Hongchang Yang ◽

Ge Chen ◽

...

Keyword(s):

Acetabular Fracture ◽

Anterior Approach ◽

Fracture Reduction ◽

Acetabular Fractures ◽

Stoppa Approach ◽

Hip Function ◽

Bony Healing ◽

Anterior Plating ◽

Simplified Procedure

Abstract Background: Solely anterior plating via the modified Stoppa approach might yield satisfactory outcomes for selected cases of complex acetabular fractures, however, its indications are not practically clear. Methods: Patients with complex acetabular fractures treated with solely anterior plating via the modified Stoppa approach with or without a lateral window at our trauma center between January 2013 and December 2019 were retrospectively reviewed. Fracture type was identified according the newly established three-column classification of acetabular fracture. Perioperative information was recorded, and fracture reduction was evaluated radiographically at 3 days postoperatively. Postoperative hip function was assessed at least 1 year postoperatively. Results: Twenty patients were included with an average 17 months (range, 13-28) follow-up. According to the three-column classification, 2 cases were classified as type B2.2, 8 cases as type B2.3, 3 cases as type C1, and 7 cases as type C3. The mean time from injury and surgery was 7.0 days (range, 3-13 days), operative time was 2.0 hours (range, 1.4-3.2 hours), and intraoperative blood loss was 320 ml (range, 220-450 ml). Fracture reduction was excellent in 15 cases (75%), good in 3 cases (15%), fair in 1 case (5%), and poor in 1 case (5%). Final hip function was excellent in 13 cases (68%), good in 3 cases (16%), fair in 2 cases (11%), and poor in 1 case (5%). Bony healing was achieved in all cases and few complications were reported including recoverable obturator nerve injuries in 2 patients (10%) and controllable osteoarthritis in 1 patient (5%). Conclusions: Solely anterior plating via the combined anterior approach achieved satisfactory mid-term outcomes for complex acetabular fractures with posterior column detachments. Based on the newly established three-column classification of complex acetabular fracture, the type B, C1, and C3 fractures are possibly the appropriate indications for such a simplified procedure.

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Mid-term Results of an Anterior Plating Via Combined Anterior Approach for complex Acetabular Fractures: A Retrospective Cohort Study

10.21203/rs.3.rs-51697/v1 ◽

2020 ◽

Author(s):

Weikun Meng ◽

Yi Ou ◽

Zhaoxiang Wu ◽

Hongchang Yang ◽

Ge Chen ◽

...

Keyword(s):

Acetabular Fracture ◽

Anterior Approach ◽

Fracture Reduction ◽

Acetabular Fractures ◽

Stoppa Approach ◽

Hip Function ◽

Bony Healing ◽

Anterior Plating ◽

Simplified Procedure

Abstract Background: Solely anterior plating via the modified Stoppa approach might yield satisfactory outcomes for selected cases of complex acetabular fractures, however, its indications are not practically clear. Methods: Patients with complex acetabular fractures treated with solely anterior plating via the modified Stoppa approach with or without a lateral window at our trauma center between January 2013 and December 2019 were retrospectively reviewed. Fracture type was identified according the newly established three-column classification of acetabular fracture. Perioperative information was recorded, and fracture reduction was evaluated radiographically at 3 days postoperatively. Postoperative hip function was assessed at least 1 year postoperatively. Results: Twenty patients were included with an average 17 months (range, 13-28) follow-up. According to the three-column classification, 2 cases were classified as type B2.2, 8 cases as type B2.3, 3 cases as type C1, and 7 cases as type C3. The mean time from injury and surgery was 7.0 days (range, 3-13 days), operative time was 2.0 hours (range, 1.4-3.2 hours), and intraoperative blood loss was 320 ml (range, 220-450 ml). Fracture reduction was excellent in 15 cases (75%), good in 3 cases (15%), fair in 1 case (5%), and poor in 1 case (5%). Final hip function was excellent in 13 cases (68%), good in 3 cases (16%), fair in 2 cases (11%), and poor in 1 case (5%). Bony healing was achieved in all cases and few complications were reported including recoverable obturator nerve injuries in 2 patients (10%) and controllable osteoarthritis in 1 patient (5%). Conclusions: Solely anterior plating via the combined anterior approach achieved satisfactory mid-term outcomes for complex acetabular fractures with posterior column detachments. Based on the newly established three-column classification of complex acetabular fracture, the type B, C1, and C3 fractures are possibly the appropriate indications for such a simplified procedure.Trial registration informationThe trial was retrospectively registered in https://www.researchregistry.com (No. Researchregistry4862) on July 04, 2019. The first participant was enrolled on March 06, 2017.

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