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BioMed Research International
Volume 2016 (2016), Article ID 4094161, 9 pages
Research Article

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

1Department of Trauma, Hand and Reconstructive Surgery, University of Rostock, Medical Center, Schillingallee 35, 18057 Rostock, Germany
2Clinic for Anesthesiology and Critical Care Medicine, University of Rostock, Medical Center, Schillingallee 35, 18059 Rostock, Germany
3Institute for Biomedical Engineering, University of Rostock, F. Barnewitz-Straße 4, 18119 Rostock, Germany
4Faculty of Mechanical Engineering and Marine Technology, Chair of Mechanical Engineering Design/Lightweight Design, University of Rostock, Albert-Einstein-Straße 2, 18059 Rostock, Germany
5Rudolf-Zenker Institute for Experimental Surgery, University of Rostock, Medical Center, Schillingallee 69a, 18057 Rostock, Germany
6Department of Trauma, Orthopedic and Reconstructive Surgery, Munich Municipal Hospital Group, Clinic Harlaching, Sanatoriumsplatz 2, 81545 Munich, Germany

Received 12 November 2015; Accepted 4 February 2016

Academic Editor: Carmine Zoccali

Copyright © 2016 Anica Eschler et al. 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.


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, 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.