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

Introduction. Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF mo...

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Autores principales: Eschler, Anica, Roepenack, Paula, Roesner, Jan, Herlyn, Philipp Karl Ewald, Martin, Heiner, Reichel, Martin, Rotter, Robert, Vollmar, Brigitte, Mittlmeier, Thomas, Gradl, Georg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785241/
https://www.ncbi.nlm.nih.gov/pubmed/27019848
http://dx.doi.org/10.1155/2016/4094161
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author Eschler, Anica
Roepenack, Paula
Roesner, Jan
Herlyn, Philipp Karl Ewald
Martin, Heiner
Reichel, Martin
Rotter, Robert
Vollmar, Brigitte
Mittlmeier, Thomas
Gradl, Georg
author_facet Eschler, Anica
Roepenack, Paula
Roesner, Jan
Herlyn, Philipp Karl Ewald
Martin, Heiner
Reichel, Martin
Rotter, Robert
Vollmar, Brigitte
Mittlmeier, Thomas
Gradl, Georg
author_sort Eschler, Anica
collection PubMed
description Introduction. Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1) evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs) and (2) demonstrate the healing capabilities in osteoporotic VCFs. Methods. Twelve 5-year-old Merino sheep received ovariectomy, corticosteroid injections, and a calcium/phosphorus/vitamin D-deficient diet for osteoporosis induction. Standardized VCFs (type AO A3.1) were created, reduced, and fixed using intravertebral TMIs. Randomly additional autologous spongiosa grafting (G1) or no augmentation was performed (G2, n = 6 each). Two months postoperatively, macroscopic, micro-CT and biomechanical evaluation assessed bony consolidation. Results. Fracture reduction succeeded in all cases without intraoperative complications. Bony consolidation was proven for all cases with increased amounts of callus development for G2 (58.3%). Micro-CT revealed cage integration. Neither group showed improved results with biomechanical testing. Conclusions. Fracture reduction/fixation using TMIs without cement in osteoporotic sheep lumbar VCF resulted in bony fracture healing. Intravertebral application of autologous spongiosa showed no beneficial effects. The technique is now available for clinical use; thus, it offers an opportunity to abandon cement-associated complications.
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spelling pubmed-47852412016-03-27 Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model Eschler, Anica Roepenack, Paula Roesner, Jan Herlyn, Philipp Karl Ewald Martin, Heiner Reichel, Martin Rotter, Robert Vollmar, Brigitte Mittlmeier, Thomas Gradl, Georg Biomed Res Int Research Article Introduction. Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1) evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs) and (2) demonstrate the healing capabilities in osteoporotic VCFs. Methods. Twelve 5-year-old Merino sheep received ovariectomy, corticosteroid injections, and a calcium/phosphorus/vitamin D-deficient diet for osteoporosis induction. Standardized VCFs (type AO A3.1) were created, reduced, and fixed using intravertebral TMIs. Randomly additional autologous spongiosa grafting (G1) or no augmentation was performed (G2, n = 6 each). Two months postoperatively, macroscopic, micro-CT and biomechanical evaluation assessed bony consolidation. Results. Fracture reduction succeeded in all cases without intraoperative complications. Bony consolidation was proven for all cases with increased amounts of callus development for G2 (58.3%). Micro-CT revealed cage integration. Neither group showed improved results with biomechanical testing. Conclusions. Fracture reduction/fixation using TMIs without cement in osteoporotic sheep lumbar VCF resulted in bony fracture healing. Intravertebral application of autologous spongiosa showed no beneficial effects. The technique is now available for clinical use; thus, it offers an opportunity to abandon cement-associated complications. Hindawi Publishing Corporation 2016 2016-02-25 /pmc/articles/PMC4785241/ /pubmed/27019848 http://dx.doi.org/10.1155/2016/4094161 Text en Copyright © 2016 Anica Eschler et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Eschler, Anica
Roepenack, Paula
Roesner, Jan
Herlyn, Philipp Karl Ewald
Martin, Heiner
Reichel, Martin
Rotter, Robert
Vollmar, Brigitte
Mittlmeier, Thomas
Gradl, Georg
Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model
title Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model
title_full Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model
title_fullStr Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model
title_full_unstemmed Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model
title_short Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model
title_sort cementless titanium mesh fixation of osteoporotic burst fractures of the lumbar spine leads to bony healing: results of an experimental sheep model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785241/
https://www.ncbi.nlm.nih.gov/pubmed/27019848
http://dx.doi.org/10.1155/2016/4094161
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