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Transpedicular vertebral body augmentation reinforced with pedicle screw fixation in fresh traumatic A2 and A3 lumbar fractures: comparison between two devices and two bone cements

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Abstract

This retrospective study compares efficacy and safety of balloon kyphoplasty (BK) with calcium phosphate (Group A) versus KIVA implant with PMMA (Group B) reinforced with three vertebrae pedicle screw constructs for A2 and A3 single fresh non-osteoporotic lumbar (L1–L4) fractures in 38 consecutive age- and diagnosis-matched patient populations. Extracanal leakage of both low-viscosity PMMA and calcium phosphate (CP) as well as the following roentgenographic parameters: segmental kyphosis (SKA), anterior (AVBHr) and posterior (PVBHr) vertebral body height ratio, spinal canal encroachment (SCE) clearance, and functional outcome measures: VAS and SF-36, were recorded and compared between the two groups. All patients in both groups were followed for a minimum 26 (Group A) and 25 (Group B) months. Extracanal CP and PMMA leakage was observed in four (18 %) and three (15 %) vertebrae/patients of group A and B, respectively. Hybrid fixation improved AVBHr, SKA, SCE, but PVBHr only in group B. VAS and SF-36 improved postoperatively in the patients of both groups. Short-segment construct with the novel KIVA implant restored better than BK-fractured lumbar vertebral body, but this had no impact in functional outcome. Since there was no leakage difference between PMMA and calcium phosphate and no short-term adverse related to PMMA use were observed, we advice the use of PMMA in fresh traumatic lumbar fractures.

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References

  1. Olerud S, Karlström G, Sjöström L (1988) Transpedicular fixation of thoracolumbar vertebral fractures. Clin Orthop Relat Res 227:44-51.22744

    Google Scholar 

  2. McLain RF, Sparling E, Benson DR (1993) Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report. J Bone Joint Surg Am 75:162-7.75162

    Google Scholar 

  3. McCormack T, Karaikovic E, Gaines RW. (1994) The load sharing classification of spine fractures. Spine 19:1741-4.191741

    Google Scholar 

  4. Korovessis P, Baikousis A, Zacharatos S et al (2006) Combined anterior plus posterior stabilization versus posterior short-segment instrumentation and fusion for mid-lumbar (L2–L4) burst fractures. Spine 31:859–868

    Article  PubMed  Google Scholar 

  5. Korovessis P, Hadjipavlou A, Repantis Th (2008) Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures. Spine 33:658–667

    Article  PubMed  Google Scholar 

  6. Eck JC, Nachtigall D, Humphreys SC, Hodges SD (2008) Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine 8:488–497

    Article  Google Scholar 

  7. Christensen BF, Laursen M, Gelineck J et al (2001) Interobserver and intraobserver agreement of radiograph interpretation with and without pedicle screw implants. Spine 26:538–544

    Article  CAS  PubMed  Google Scholar 

  8. Korovessis P, Repantis T, Miller LE et al (2011) Initial clinical experience with a novel vertebral augmentation system for treatment of symptomatic vertebral compression fractures: a case series of 26 consecutive patients. BMC Musculoskelet Disord 22(12):206–209

    Article  Google Scholar 

  9. Verlaan JJ, Dhert WJ, Verbout AJ et al (2005) Balloon vertebroplasty in combination with pedicle screw instrumentation: a novel technique to treat thoracic and lumbar burst fractures. Spine 30:E73–E79

    Article  PubMed  Google Scholar 

  10. Verlaan JJ, van de Kraats EB, Oner FC et al (2005) Bone displacement and the role of longitudinal ligaments during balloon vertebroplasty in traumatic thoracolumbar fractures. Spine 30:1832–1839

    Article  PubMed  Google Scholar 

  11. Bohner M, Gasser B, Baroud G, Heini P (2003) Theoretical and experimental model to describe the injection of a polymethylmethacrylate cement into a porous structure. Biomaterials 24(16):2721–2730

    Article  CAS  PubMed  Google Scholar 

  12. Choe DH, Marom EM, Ahrar K et al (2004) Pulmonary embolism of polymethylmethacrylate during percutaneous vertebroplast and kyphoplasty. Am J Roentenol 183:1097–1102

    Article  Google Scholar 

  13. Yu SW, Chen WJ, Lin WC et al (2004) Serious pyogenic spondylitis following vertebroplasty: a case report. Spine 29:E209–E211

    Article  PubMed  Google Scholar 

  14. Yoo KY, Jeong SW, Yoon W, Lee J (2004) Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate. Spine 29:E294–E297

    Article  PubMed  Google Scholar 

  15. Galibert P, Dearamond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168

    CAS  PubMed  Google Scholar 

  16. Chen HL, Wong CS, Ho ST et al (2002) A lethal pulmonary embolism during percutaneous vertebroplasty. Anesth Analg 95:1060–1062

    PubMed  Google Scholar 

  17. Alanay A, Acaroglu E, Yazici M et al (2001) Short-segment pedicle instrumentation of thoracolumbar burst fractures: does transpedicular intracorporeal grafting prevent early failure? Spine 26:213–217

    Article  CAS  PubMed  Google Scholar 

  18. Kramer DL, Rodgers WB, Mansfield FL (1995) Transpedicular instrumentation and short-segment fusion of thoracolumbar fractures: a prospective study using a single instrumentation system. J Orthop Trauma 9:499–506

    Article  CAS  PubMed  Google Scholar 

  19. McLain RF, Sparling E, Benson DR (1993) Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. J Bone Joint Surg Am 75:162–167

    CAS  PubMed  Google Scholar 

  20. Wang ST, Ma HL, Liu CL, Yu WK, Chang MC, Chen TH (2006) Is fusion necessary for surgically treated burst fractures of the thoracolumbar and lumbar spine? A prospective, randomized study. Spine (Phila Pa 1976) 31:2646–2652

    Article  Google Scholar 

  21. Dai LY, Jiang LS, Jiang SD (2009) Posterior short-segment fixation with or without fusion for thoracolumbar burst fractures. A five to seven-year. J Bone Joint Surg Am 91:1033–1041

    Article  PubMed  Google Scholar 

  22. Toyone T, Tanaka T, Kato D et al (2006) The treatment of acute thoracolumbar burst fractures with transpedicular intracorporeal hydroxyapatite grafting following indirect reduction and pedicle screw fixation: a prospective study. Spine 31:208–214

    Article  Google Scholar 

  23. Li KC, Li Anna F-Y, Hsieh CH et al (2007) Transpedicle body augmenter in painful osteoporotic compression fractures. Eur Spine J 16:589–598

    Article  PubMed Central  PubMed  Google Scholar 

  24. Deramond H, Wright N, Belkoff S (1999) Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone 25:17–21

    Article  Google Scholar 

  25. Lim TH, Brebach GT, Renner SM et al (2002) Biomechanical evaluation of an injectable calcium phosphate cement for vertebroplasty. Spine 27:1297–1302

    Article  PubMed  Google Scholar 

  26. Tomita S, Molloy S, Jasper LE et al (2004) Biomechanical comparison of kyphoplasty with different bone cements. Spine 29:1203–1207

    Article  PubMed  Google Scholar 

  27. Mahar A, Kim Choll, Wedemeyer M et al (2007) Short-segment fixation of lumbar burst fractures using pedicle fixation at the level of the fracture. Spine 32:1503–1507

    Article  PubMed  Google Scholar 

  28. Fribourg D, Tang C, Sra P, Delamarter R, Bae H (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29:2270–2277

    Article  PubMed  Google Scholar 

  29. Kim D-Y, Lee S-H, Chung SK et al (2005) Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. Spine 32:123–129

    Article  Google Scholar 

  30. Schizas C, Michel J, Kosmopoulos V et al (2007) Computer tomography assessment of pedicle screw insertion in percutaneous posterior transpedicular stabilization. Eur Spine J 16:613–617

    Article  PubMed Central  PubMed  Google Scholar 

  31. Park Y, Won HJ, Lee TY, Sung YN (2011) Percutaneous placement of pedicle screws in overweight and obese patients. Spine J 11:919–924

    Article  PubMed  Google Scholar 

  32. Korovessis P, Vardakastanis K, Repantis T et al (2013) Balloon kyphoplasty versus KIVA vertebral augmentation—comparison of 2 techniques for osteoporotic vertebral body fractures: a prospective randomized study. Spine 38(4):292–299

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Orthopaedic Department, General Hospital “Agios Andreas”, Charalabi Str. 65-67, Patras, Greece

    Panagiotis Korovessis, Konstantinos Vardakastanis, Thomas Repantis & Vasilios Vitsas

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  1. Panagiotis Korovessis
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  2. Konstantinos Vardakastanis
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  3. Thomas Repantis
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  4. Vasilios Vitsas
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Correspondence to Panagiotis Korovessis.

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Korovessis, P., Vardakastanis, K., Repantis, T. et al. Transpedicular vertebral body augmentation reinforced with pedicle screw fixation in fresh traumatic A2 and A3 lumbar fractures: comparison between two devices and two bone cements. Eur J Orthop Surg Traumatol 24 (Suppl 1), 183–191 (2014). https://doi.org/10.1007/s00590-013-1296-9

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  • DOI: https://doi.org/10.1007/s00590-013-1296-9

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