Article
Result presentation of a series of 13 lumbar implantations of the B-Twin Expandable Spinal System (B-Twin ESS) by a posterior approach
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Published: | May 20, 2009 |
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Introduction: In patients with severe spondylosis and accompanying (pseudo-)spondylolisthesis vertebral fusion promises pain relief along with the stabilization of vertebral shifting. In this study we evaluated the outcome after implantation of the “B-Twin Expandable Spinal System” (B-Twin ESS) through an open posterior approach.
Materials and Methods: 13 consecutive patients (6 males & 7 females) with a mean age of 67 years, presenting with degenerative disc disease and (pseudo-)spondylolisthesis grade 1 according to Meyerding were treated with a B-Twin ESS in the involved spinal segment.
The analyzed five parameters: (1) number of sequel operations, (2) wound infection, (3)procedural complications, (4) segment stability, (5) ease of handling, and (6) patient satisfaction.
Results: Unfortunately, the results were very disappointing. 6/13 patients (46%) underwent a sequel operation (revision) because of wound infections and a spinal liquor leakage. A bland aseptic spondylodiscitis was observed in 3 patients (23%), while 6 patients (46%) revealed a fracture of the adjacent end plates and a dislocated cage bulging into the vertebral body.
Because of the unsatisfactory results we stopped the implantation of the (lumbar) B-Twin Expandable Spinal Systems.
Conclusions: Only 2/13 patients (15%) had a favorable outcome, while 85% suffered from side effects and complications like inflammation, liquor leak and endplate erosion. In our opinion these results have to be regarded as unfavorable and dissatisfying, driving us to end the series at this point. Hypothetically, the reason for this poor outcome may be seen in the inadequately small interlaminar access for maneuvering the bulky device into the shrunk disk space.