Distractible vertebral body replacement for
the thoracic and lumbar spine
Published online: Aug 27 2005
Benjamin ULMAR, Marcus RICHTER, Georg KELSCH, Balkan CAKIR, Wolfhart PUHL, Klaus HUCH
From Department of Orthopaedics, University of Ulm and Spine Center, St Joseph Hospital Wiesbaden, Germany
Abstract
We retrospectively evaluated the results after corporectomy
and vertebral body replacement in
40 patients with thoracic or lumbar spine collapse
due to tumour osteolysis, unstable fractures, spondylodiscitis
and Paget's disease. They underwent posterior
transpedicular instrumentation followed 7 to
21 days later by vertebral body replacement with a
distractible device, the “Obelisc” cage, filled up with
autogenous/allogeneic bone graft. The mean residual
kyphosis after surgery was only 13.8°. After a mean
follow-up period of 16.3 months, there was a mean
loss of correction of 1.1°. Perioperative complications
occurred in 25 patients (62.5%) ; one died of septic
schock, and the others were treated conservatively.
Postoperatively, neurological improvement was
noted in 8 patients. Using this in situ distractible vertebral
body replacement system to achieve intraoperative
stabilisation, neurological improvement
and minimal postoperative displacement were
achieved with an acceptable perioperative risk.