Journal: Journal of Functional Biomaterials

Article Title: The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective

doi: 10.3390/jfb14070341

Figure Lengend Snippet: First case report from 1999 by Cobos et al. on the treatment of a patient (34-year-old) with post-traumatic segmental defect of the tibia (8.5 cm) with a cylindrical (spinal) titanium mesh cage in combination with cancellous bone allograft and demineralized bone matrix putty (Grafton) stabilized with an intramedullary nail. The titanium mesh cage was trimmed to 9 cm (diameter 2.2 cm) to fit the defect size and packed with allograft prior to implantation ( A ). Posterolateral callus consolidation around the cage on X-ray (views: ( B1 ): anterior–posterior; ( B2 ): lateral) 12 months post-reconstruction. Standing patient ( C1 ) and standing on the operated limb ( C2 ) at one-year follow-up. Adapted from Ref. , reproduced with permission from John Wiley & Sons, Inc.

Article Snippet: Following these case reports, major trauma centres worldwide began to apply cylindrical titanium mesh implants either as the previously described cylindrical (spinal) titanium mesh cage (DePuy-Synthes, Warsaw, Indiana) as reported in 17 patients by Attias et al. [ ] or as a cylindrical 3D additive manufactured titanium mesh cages as reported in 19 patients by Pobloth et al. [ ].

Techniques:

Journal: Journal of Functional Biomaterials

Article Title: The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective

doi: 10.3390/jfb14070341

Figure Lengend Snippet: Exemplary challenges and failures in the use of cylindrical titanium mesh cage implants for bone defects. X-ray of a 29-year-old male with a segmental tibial defect and treatment for definitive fixation with an intramedullary nail and cylindrical titanium mesh cage (DePuy Synthes) ( A ). The asterisks in A1 highlight the graft material four months after grafting, which is packed into and on the outer surface of the cylindrical mesh implant. After 90 months, there is stagnation in the bony consolidation on the surface of the implant (asterisks) compared to plain radiography findings after four months and, in particular, no evidence of a bony structure within the cylindrical titanium mesh cage (triangles) (( B1) : anterior–posterior; ( B2 ): lateral). Patient-specific titanium mesh implant (DePuy Synthes) packed with RIA system graft material implanted to treat a femoral defect ( C ). Twenty-eight months after implantation, a subtle but distinctive callus formed bridging the defect on the implant surface (( D ), asterisks indicating bone bridge). However, no bony consolidation was observed in the inner part of the titanium mesh. The triangles in D indicate that the mesh structure is radiolucent, which would not be possible if ABG remodelling and thus successful regeneration of the graft material of the RIA system had occurred. ( A , B ): reproduced from Supplement of Ref. , with permission from the British Editorial Society of Bone & Joint Surgery; ( C ): reproduced from Supplement of Ref. , reprinted with permission from American Association for the Advancement of Science (AAAS).

Article Snippet: Following these case reports, major trauma centres worldwide began to apply cylindrical titanium mesh implants either as the previously described cylindrical (spinal) titanium mesh cage (DePuy-Synthes, Warsaw, Indiana) as reported in 17 patients by Attias et al. [ ] or as a cylindrical 3D additive manufactured titanium mesh cages as reported in 19 patients by Pobloth et al. [ ].

Techniques:

Journal: Neurospine

Article Title: Mechanical Failure After Total En Bloc Spondylectomy and Salvage Surgery

doi: 10.14245/ns.2244092.046

Figure Lengend Snippet: Reconstruction of 3 columns after total en bloc spondylectomy (TES). (A) After TES at T12, the anterior vertebral column is supported by a titanium-based mesh-type interbody cage, and the posterior column is supported by pedicle screws and a 5.5-mm rod on each side. (B) Cadaveric bone was tailored and fixed with a plate and screw system for bone fusion between intact laminas (arrow).

Article Snippet: A titanium-based mesh-type interbody spacer (SynMesh system, Depuy Synthes, MA, USA) filled with autologous and cadaveric bone was used for anterior support, and a pedicle screw/rod system (Expedium, Depuy Synthes, Raynham, MA, USA; Legacy, Medtronics, Memphis, TN, USA) was used for posterior support.

Techniques:

Journal: Neurospine

Article Title: Mechanical Failure After Total En Bloc Spondylectomy and Salvage Surgery

doi: 10.14245/ns.2244092.046

Figure Lengend Snippet: Total en bloc spondylectomy for recurrent giant cell tumor. T2-weighted magnetic resonance images show a mass across T6/7 in axial (A, arrow) and coronal (B) views. The tumor extended to the vertebral body, epidural space transverse process, and ribs. A postoperative x-ray shows instrumentation from T4 to T9, but the vertebral bodies are not resected (C). Positron emission tomography shows high uptake (D, arrow) in the left T6 vertebral body. Presurgical planning is marked on a 3-dimensional posterior (E) image with bold lines. (F) An intraoperative specimen shows a resected vertebra. The tumor was in the left vertebral body, pedicle, and transverse process, and those structures were removed in an en bloc fashion after resecting posterior spinal elements, as marked with a bold line (E). (G) An intraoperative photo shows posterior reconstruction with a pedicle/screw system and cadaveric bone bloc and chips. (H) A postoperative x-ray shows anterior column support with a mesh-type interbody space. (I) X-ray shows a unilateral rod fracture (arrow). (J) Sagittal computed tomography shows nonunion between the cage and T8 (arrow). (K) X-ray taken 6 months later showed a bilateral rod fracture (arrow). (L) The broken screws were replaced with cobalt-chromium alloy rods, and additional rods were applied.

Article Snippet: A titanium-based mesh-type interbody spacer (SynMesh system, Depuy Synthes, MA, USA) filled with autologous and cadaveric bone was used for anterior support, and a pedicle screw/rod system (Expedium, Depuy Synthes, Raynham, MA, USA; Legacy, Medtronics, Memphis, TN, USA) was used for posterior support.

Techniques: Positron Emission Tomography, Computed Tomography