PMID- 28407019
OWN - NLM
STAT- MEDLINE
DCOM- 20170421
LR  - 20170504
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - Comparison between titanium mesh and autogenous iliac bone graft to restore
      vertebral height through posterior approach for the treatment of thoracic and
      lumbar spinal tuberculosis.
PG  - e0175567
LID - 10.1371/journal.pone.0175567 [doi]
AB  - OBJECT: To compare the clinical efficacy of titanium mesh cages and autogenous
      iliac bone graft to restore vertebral height through posterior approach in
      patients with thoracic and lumbar spinal tuberculosis. METHOD: 59 patients with
      spinal tuberculosis underwent interbody fusion and internal fixation through
      posterior approach in our department from January 2011 to December 2013. In group
      A, 34 patients obtained titanium mesh for the reconstruction of vertebral height,
      among them 25 patients (group A1) suffered from single-segment spinal
      tuberculosis, and 9 patients, (group A2) had multi-segment spinal tuberculosis.
      In group B, 25 patients got autogenous iliac bone graft to restore vertebral
      height, including 24 patients with single-segment spinal tuberculosis (group B1),
      and 1 patient with multi-segment spinal tuberculosis (group B2). The clinical
      efficacy was evaluated based on average operation time, blood loss, hospital
      stays, hospitalization expenses, visual analog scale (VAS), Oswestry Disability
      Index (ODI), erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP),
      neurological function recovery, bony fusion, intervertebral height, Cobb angle
      and postoperative complications. RESULTS: Final follow-up time was an average of 
      35.5 months ranging from 15 to 56 months. All patients were completely cured and 
      obtained solid bone fusion. The bony fusion time was 9.4+/-6.1 months in group
      A1, 10.2+/-2.7 months in group A2 and 8.7+/-3.6 months in group B1. There were no
      significant difference among three groups (P>0.05). The Cobb correction and
      restoration of intervertebral height significantly improved compared with those
      in preoperation, but without significant difference among three groups (P>0.05). 
      The loss of angular correction and intervertebral height in group A1 were found
      to be less than those in group B1 (P<0.05), but with no significant difference
      between group A1 and group A2, and between group A2 and group B1 (P>0.05).
      Patients in group B1 got the most loss of angular correction and intervertebral
      height. In addition, neurological function was revealed to be significantly
      improved after surgery. There were significant differences of VAS, ODI, ESR and
      CRP between preoperation and postoperation at the final follow-up time (P<0.05), 
      with no significant difference among three groups (P>0.05). No statistically
      significant difference was found when analyzing blood loss, hospital stays,
      hospitalization expenses, and corrective cost among three groups (P>0.05).
      Complications included cerebrospinal fluid leakage (2 cases in group A1 and group
      A2), sinus formation (3 cases in group A1, group A2 and group B1), and
      intervertebral infection (1 case in group B1), but no implant failure or donor
      site complications was found in any patient. CONCLUSIONS: Titanium mesh cages
      could obtain good clinical efficacy comparable to autogenous iliac bone graft
      when treating single-segment spinal tuberculosis, and may be better than
      autogenous iliac bone graft for treating multi-segment spinal tuberculosis.
FAU - Gao, Yongjian
AU  - Gao Y
AD  - Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical
      University, Chongqing, P.R. China.
FAU - Ou, Yunsheng
AU  - Ou Y
AUID- ORCID: http://orcid.org/0000-0001-8578-3523
AD  - Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical
      University, Chongqing, P.R. China.
FAU - Deng, Qianxing
AU  - Deng Q
AD  - Department of Orthopedics, the Fengdu people's Hospital of Chongqing, Chongqing, 
      P.R. China.
FAU - He, Bin
AU  - He B
AD  - Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical
      University, Chongqing, P.R. China.
FAU - Du, Xing
AU  - Du X
AD  - Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical
      University, Chongqing, P.R. China.
FAU - Li, Jianxiao
AU  - Li J
AD  - Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical
      University, Chongqing, P.R. China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20170413
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - D1JT611TNE (Titanium)
SB  - IM
MH  - Adult
MH  - Bone Transplantation/*methods
MH  - Female
MH  - Fracture Fixation, Internal/*methods
MH  - Humans
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - Reconstructive Surgical Procedures/instrumentation
MH  - Spinal Fusion/*methods
MH  - Surgical Mesh/utilization
MH  - Thoracic Vertebrae/*surgery
MH  - Titanium
MH  - Treatment Outcome
MH  - Tuberculosis, Spinal/*surgery
PMC - PMC5391077
EDAT- 2017/04/14 06:00
MHDA- 2017/04/22 06:00
CRDT- 2017/04/14 06:00
PHST- 2016/09/11 00:00 [received]
PHST- 2017/03/28 00:00 [accepted]
PHST- 2017/04/14 06:00 [entrez]
PHST- 2017/04/14 06:00 [pubmed]
PHST- 2017/04/22 06:00 [medline]
AID - 10.1371/journal.pone.0175567 [doi]
AID - PONE-D-16-33697 [pii]
PST - epublish
SO  - PLoS One. 2017 Apr 13;12(4):e0175567. doi: 10.1371/journal.pone.0175567.
      eCollection 2017.