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Microradiographic and Histopathologic Findings in a Human Cage Explant After Two-Level Corpectomy: A Case Report

Klemme, LTC William R., MD,*; Cunningham, Bryan W., MSc,†; Polly, LTC David W. Jr,, MD*

Case Report
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Study Design.  A case involving microradiographic and histopathologic analysis of an explanted human corpectomy mesh cage is reported.

Objective.  To describe the clinical circumstance, the radiographic appearance, and the histopathologic assessment of a titanium mesh device explanted from a two-level corpectomy.

Summary of Background Data.  To the authors’ knowledge, no published microradiographic or histopathologic reports have described a retrieved human corpectomy cage.

Methods. The explanted device was stained using Osteochrome Villanueva bone stain and underwent routine decalcified histologic processing and embedding in polymethylmethacrylate. Midsagittal sections were prepared and polished to 100 μm for histologic and microradiographic analysis.

Results.  Microscopic analysis demonstrated normal-appearing lamellar and woven trabecular bone in close contact with the titanium implant interface. Further analysis of serial sections indicated that, on the average, 35% (range, 30–40%) of the inner device region contained trabecular bone.

Conclusion.  Osteosynthesis and bone remodeling can occur within titanium corpectomy cages.

Methods.  This study involved one titanium mesh device (Harms cage), 20 mm in diameter and 45 mm long, explanted from a two-level corpectomy clinical case. This device was retrieved, processed, and analyzed after informed patient consent and approval from the authors’ institutional review board.

From the *Department of Orthopaedic Surgery and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, the Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and the

†Orthopaedic Biomechanics Laboratory, Union Memorial Hospital, Baltimore, Maryland.

This investigation was performed at the Walter Reed Army Medical Center, Washington, DC, and the Orthopaedic Biomechanics Laboratory, Union Memorial Hospital, Baltimore.

The opinions or assertions contained in this report are the private views of the authors, and are not to be construed as official or as reflecting the views of the United States Army or the Department of Defense. Three of the authors are employees of the United States government. This work was prepared as part of their official duties and, as such, there is no copyright to be transferred.

Acknowledgment date: April 16, 2001.

First revision date: July 6, 2001.

Acceptance date: July 9, 2001.

Device status category: 11.

Conflict of interest category: 12,15.

Address reprint requests to

LTC William R. Klemme, MD

Department of Orthopaedics and Rehabilitation

Walter Reed Army Medical Center

7100 Georgia Avenue NW

Washington, DC 20307

E-mail: William.Klemme@na.amedd.army.mil

© 2002 Lippincott Williams & Wilkins, Inc.