Monitoring the load on a telemeterised vertebral body replacement for a period of up to 65 months.

Abstract

To determine the postoperative temporal course of the forces acting on a vertebral body replacement (VBR) for two well reproducible activities. A telemeterised VBR was implanted in five patients. It allows the measurement of six load components. Implant loads were measured in up to 28 measuring sessions for different activities, including standing and walking. The postoperative temporal course of the resultant implant forces measured during standing and walking was similar in each patient, but the patterns varied strongly from patient to patient. In one patient, the forces decreased in the first year and then increased in the following 4 years. In another patient, the forces increased in the first few months and then decreased. In a third patient, the forces varied only slightly in the postoperative time. In two patients, there was a strong drop of the implant force in the first two postoperative months. The force was on average approximately 100 N or 71% higher for walking than for standing. The strong force reduction in the first 2 months is most likely caused by implant subsidence, and the force reduction over a period of more than 6 months is most likely caused by fusion of the vertebrae adjacent to the VBR. The short-term force increase could be attributed to bone atrophy at the index level, and the long-term force increase could be attributed to an increase in the thoracic spine kyphosis angle.