THE USE OF TITANIUM MESH FOR DEFECT CLOSURE AFTER POSTERIOR SPINAL DECOMPRESSION

ABSTRACT Objective: The number of revision surgical interventions for degenerative spine disorders has increased steadily. However, the formation of adhesions is one of the more serious conditions accompanying this type of surgery. There are some generally accepted options for its prevention, such as delicate surgical technique, preserving the integrity of spinal canal, and the use of different synthetic materials in the form of gels, plates and membranes to delimit the dural sac from the surrounding soft tissues. The main disadvantages of the described methods are their high cost and the need for a large volume of material in prolonged surgical interventions. Therefore, the development of new methods for prevention of adhesions formations is of paramount importance. The use of titanium mesh is, potentially, an effective and relatively cheap method of preventing the formation of adhesions in spinal surgeries. Methods: We have prospectively analyzed the outcomes of treatment of 40 patients suffering from degenerative spine disease who underwent surgical intervention with titanium mesh implantation in our department between October 2017 and December 2017. Conclusion: The results of our study led us to conclude that the use of titanium mesh enables the surgeon to delimit the dural sac in multilevel spinal decompression surgeries, contributing to closure of the defect in spinal canal and significantly reducing treatment costs. Level of evidence III; Control Case Study.

摘要
目的：退行性脊柱疾病的翻修手术数量持续攀升。粘连形成是此类手术伴随的较为严重的并发症之一。目前已有若干公认的预防方案，例如采用精细手术操作、维持椎管完整性，以及使用凝胶、钢板、膜片等各类合成材料，将硬脊膜囊与周围软组织相分隔。上述方法的主要弊端为成本高昂，且在长时程手术中需要大量耗材。因此，研发新型粘连形成预防方法具有至关重要的临床意义。钛网（titanium mesh）的应用有望成为一种有效且相对廉价的脊柱手术粘连预防手段。
方法：本研究前瞻性分析了2017年10月至2017年12月期间，我科收治的40例退行性脊柱疾病患者的治疗结局，所有患者均接受了钛网植入手术。
结论：本研究结果表明，在多节段脊柱减压手术中使用钛网，可帮助术者完成硬脊膜囊的分隔操作，有助于修复椎管缺损，并显著降低治疗成本。本研究证据等级为III级，属于对照病例研究。