Requirements for a Stable Long-Term Result in Surgical Reduction of Vertebral Fragility Fractures.

Requirements for a Stable Long-Term Result in Surgical Reduction of Vertebral Fragility Fractures.

World Neurosurg. 2017 May 31;:

Authors: Crespo-Sanjuán J, Ardura F, Hernández-Ramajo R, Noriega DC

Abstract
BACKGROUND: Osteoporotic vertebral fractures are one of the major health problems in the world. Minimally invasive surgical treatment has a great advantage compared to conservative treatment in treating these fractures as it eliminates the pain and functional disability. The percutaneous intravertebral expandable titanium device (SpineJack®, Vexim SA, France) has benefits compared to other kyphoplasty devices, showing results that are maintained over time and a reduction in complications. However, there is great controversy about the minimum amount of cement that should be used to achieve long-term restoration, and which is essential to minimize complications. We reviewed publications studying the maintenance of long-term restoration using this percutaneous expandable titanium device (PETD) in cadavers. In this study we show the first long-term work with patients treated with PETD, describing precise indications concerning the minimum amount of cement that should be used.
METHODS: Results were evaluated from a clinical study including 178 patient outcomes with long-term follow-up results performed by our team .
RESULTS: The mean total quantity of cement injected was 4.4 ml (25% vertebral body filling). The leakage rate was 12.9%, and all of these occurrences were asymptomatic. The mean follow-up time was 77 months (60-96 months). All clinical scales improved significantly after the procedure. A re-collapse of the treated vertebra was observed in 3 cases (1.6%), and the adjacent fracture rate was 2.2%.
CONCLUSION: From the results of our study and review of the literature, cement equivalent to 25% of the vertebral body filling volume, when combined with the titanium expandable device, seems to be sufficient to prevent re-collapse in osteoporotic and type A.3 fractures.

PMID: 28578121 [PubMed - as supplied by publisher]

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