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Ralf Kraus, Jens-Peter Stahl, Reinhard Schnettler |
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Treatment concepts in thoracolumbar vertebral fractures include conservative treatment, internal fixator, and vertebral body replacement with implants and autologous bone grafts. The role of biomaterials in these concepts is unclear. Specific properties of biodegradable osteosynthetics seem not to be suitable for an employment in spine surgery. Growth factors may get significant importance in future when the risk of ectopic bone formation in the neurogenic canal is abandoned, particularly in combination with artificial bone substitutes. Bioresorbable bone substitutes are widely in use in vertebro- and kyphoplasty at this time and seem to replace bone cements. In vertebral body replacement they are employed to enlarge the amount of autologous cancellous bone, but not as stand-alone implants. As in many other fields, the use of biomaterials in thoracolumbar spinal injuries will rapidly increase in future. |
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