Titanium Mesh in Spinal Fusion: A Case Serie

Background: Maxillofacial titanium mesh is most commonly used in reconstructive surgery for its versatility, stability, affordability, tissue tolerance, and compatibility with multiple imaging modalities. Here we describe the novel use of maxillofacial titanium mesh for spinal fusion surgery in a case series. Methods: We present three cases requiring instrumented spinal fusion. A 95-year-old women with one-month history of falls and back pain was found to have a spinal canal mass at T2-T3 and T11 burst fracture. A 32-year-old male had a L4 burst fracture following a motor vehicle accident. A 66-year-old female with one-year history of lumbar pain was diagnosed with thoracolumbar kyphosis, secondary hyperlordosis of the lumbar spine, stenosis at L4-L5, and L2-L5 spondylolisthesis. Results: Instrumented spinal fusion was carried out and maxillofacial titanium mesh was cut and contoured appropriately prior to being precisely placed over the dura mater. Post-operative imaging demonstrated adequate fixation for all cases. No intraoperative or postoperative complications occurred. Conclusions: Maxillofacial titanium mesh has long been used in maxillofacial reconstructive surgery for a variety of reasons including malleability, strength, and the distinct biocompatibility of titanium. However, titanium mesh may also be used to augment spinal fusion for tumor, trauma, and degenerative conditions without complication. Titanium mesh can offer the spine surgeon a safe, cost-effective and efficacious tool when used in spinal fusion. Future randomized controlled trials are needed to validate these findings in large sample sizes. Level of Evidence: 4.