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Long-term Titanium mesh cage implant failure after total en bloc spondylectomy due to spinal chondrosarcoma
Ezequiel Martinez1, Matias Pereira Duarte1, Gonzalo Kido1
1Hospital Italiano de Buenos Aires.
Objective:
To report an unusual titanium mesh cage failure after ten years of follow-up.
Clinical Case:
A 40-year-old woman diagnosed with low-grade spinal chondrosarcoma underwent a total en-bloc spondylenctomy (TES) surgery. This technique required a wide resection, anterior reconstruction with a titanium mesh cage (TMC), and posterior stabilization. For several years a favorable clinical outcome was achieved. After 10 years of follow-up, the patient developed acute non-traumatic low back pain without neurological repercussions. The images confirmed a rupture of the titanium cage. After ruling out tumor recurrence, the patient went through spinal instrumentation revision.
Conclusion:
Isolated TMC rupture is a rare event scarcely reported in the literature. There is a strong recommendation to instrument two levels proximal and distal to the bone defect in 360° reconstructions after a TES. Stability had likely been lost over the years due to the slow resorption of the bone graft. We consider necessary studies with a higher casuistry and level of evidence to analyze the contributing factors for the event of TMC rupture.
