Distractible vertebral body replacement in patients with malignant vertebral destruction or osteoporotic burst fractures

We studied prospectively the clinical and radiological course of 36 patients with localised spinal instability treated with vertebrectomy. A distractible titanium cage filled with polymethylmethacrylate (PMMA) in combination with transpedicular fixation was used to restore spinal stability. Mean follow-up was 16 (8–55) months. Average correction of the segmental kyphosis was 15.2° (−2–29°). During follow-up, a loss of correction of 0.9° (−2–15°) was seen. Segmental height was increased by 7.6  (0–14) mm on average with a mean loss of 1.6 (0–2) mm. Twenty-one patients without pre-operative neurological deficits were ambulatory without orthosis at discharge. Patients presenting with neurological deficits were unchanged (n=3) or improved (n=12).