Delayed Vertebral Augmentation With Spinejack Technique in A3 Type Vertebral Compression Fractures

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Congress:

ECR 2016

Poster Number:

C-0358

Type:

Scientific Exhibit

Keywords:

Demineralisation-Bone, Vertebroplasty, Percutaneous, Musculoskeletal spine, Interventional non-vascular

Authors:

J. Chiras; Paris Cedex 13/FR

DOI:

10.1594/ecr2016/C-0358

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-0358

Fig. 1: Fracture Types (Magerl Classification)

Fig. 2: Posterior wall displacement

Fig. 3: SpineJack® intravertebral implant, unexpanded and after expansion

Fig. 4: CASE 1 Pre-op radiographs

Fig. 5: CASE 1 - Post-op result

Fig. 6: CASE 2 Pre-op CT scans

Fig. 7: CASE 2 Interoperative radiographs

Fig. 8: CASE 2 Post-op CTscan

Aims and objectives

The efficacy of Spinejack® device (Vexim SA) to reduce fresh vertebral fractures (≤1 month) is wellestablished [1, 2, 3]. Vertebral augmentation with Spinejack® could be an alternative to treat such old fractures. Older painful (or symptomatic) fractures are usually treated by vertebroplasty but this technique is not able to reduce kyphosis or may be potentially dangerous in A3.2 and A3.3 fractures (Magerl classification), as it can be responsible of increased protrusion of bone fragment into the spinal canal. The objective of the study is to...

Methods and materials

Retrospective, monocentric, investigator initiated study on 19 patients (16 F, 3 M) presenting vertebral fractures with important kyphosis (11 cases) and/or intra spinal bone fragments (17 cases) were treated with Spinejack® expansion device between one month and one year after occurrence of the fracture. The vertebral augmentation was realized under general anesthesia during a short hospitalization of 2 days. Patient age: 50 – 85 Kyphosis: ≥20⁰: 12/19 patients (0 - 37⁰ max) Levels: T12:7; L1:11; L2:1 Number of fractures: 1 level: 18 patients; 4 levels:...

Results

Immediate Results Immediate Kyphosis reduction after procedure Kyphosis reduction: ≥ 25%: 76% Kyphosis reduction: ≥30%: 67% No clinical complication. Mid Term Results Bone fragment bulging : None No Clinical complication Pain reduction: VAS pre op: 6.85 (3-9) VAS post op: 2.1 (0-7) 2 patients had no significant pain reduction: 1osteoporotic patient within 1 month post-op presented an adjacent fracture successfully treated by vertebroplasty and 1 patient presenting an old fracture with important kyphosis had partial kyphosis reduction of 10% New fractures: 2/19 patients 2osteoporotic patients...

Conclusion

Vertebral augmentation with SpineJack® device is feasible in vertebrae older than 3 months. This technique is helpful to treat safely A3.2 and A3.3 fractures (Magerl classification). Significant kyphosis reduction is obtained in about 67% of cases. In case of persistent significant kyphosis post-op, adjacent vertebroplasty should be performed during the same procedure in order to reduce the risk of new fracture.

Personal information

Professor Jacques Chiras Head of Department Dept. Neuroradiology Hôpital de la Pitié Salpétrière 75013 Paris France [email protected]

References

[1]Krüger A, Baroud G, Noriega D, Figiel J, Dorschel C, Ruchholtz S, Oberkircher L. Height restoration and maintenance after treating unstable osteoporotic vertebral compression fractures by cement augmentation is dependent on the cement volume used. Clinical Biomechanics, vol. 28, no. 7, pp. 725–730, 2013. [2]D Noriega, A Krüger, F Ardura, N Hansen-Algenstaedt, F Hassel, X Barreau, J Beyerlein. Clinical Outcome after the Use of a New Craniocaudal Expandable Implant for Vertebral Compression Fracture Treatment: One Year Results from a Prospective Multicentric Study. BioMed Research International,...