Spinal reconstruction with titanium meshes in pediatric patients

Abstract

Objective. To analyze the results of using titanium meshes for anterior fusion in spinal reconstruction in pediatric patients. Material and Methods. Design: A retrospective cohort study from 2011 to 2014. Spinal reconstruction in 108 patients aged 8 months to 17 years was performed with titanium meshes filled with bone autografts. The indications for surgery were Pott’s disease (n = 41), non-specific chronic spondylitis and its sequences (n = 42), spinal tumors (n = 11) and congenital spinal deformities (n = 6). Additional posterior instrumentation was carried out in case of multilevel spinal reconstruction or for spinal deformity. Clinical and radiological FU results were evaluated at the 6, 12, 18 months after surgery with the analy- sis of infection reactivation risk, changes in the apical Cobb angle and dynamics of block formation in anterior fusion zone. Results. No cases of infection reactivation or process aggravation were detected during 6 months after surgery. Two pa- tients (with TB spondylitis and giant cell tumor) had deterioration of vertebral destruction with mesh instability in the period from 6 to 12 months after surgery. No one case of mesh stability preservation was associated with deformity pro- gression. Solid bone block was formed in 97 % of operated patients at 12 months after surgery. Conclusion. Using of meshes in reconstructive surgery on the spine in children does not increase the rate of postoperative complications even in infectious spondylitis, due to biological inertia of the non-resorbable material.

Keywords

• titanium meshes
• spine
• spinal fusion
• spinal tuberculosis
• spondylitis
• congenital spinal deformity
• spinal tu- mors
• children