Balloon vertebroplasty with calcium phosphate cement augmentation for direct restoration of traumatic thoracolumbar vertebral fractures

• Published in: Spine (Philadelphia, Pa. 1976) Vol. 27; no. 5; p. 543
• Main Authors: Verlaan, J J, van Helden, W H, Oner, F C, Verbout, A J, Dhert, W J A
• Format: Journal Article
• Language: English
• Published: United States 01.03.2002
• Subjects: Aged; Aged, 80 and over; Biocompatible Materials - administration & dosage; Biocompatible Materials - adverse effects; Bone Cements - adverse effects; Bone Cements - therapeutic use; Cadaver; Calcium Phosphates - administration & dosage; Calcium Phosphates - adverse effects; Feasibility Studies; Female; Fluoroscopy; Fracture Fixation - adverse effects; Fracture Fixation - methods; Humans; Injections; Internal Fixators; Kyphosis - prevention & control; Lumbar Vertebrae - drug effects; Lumbar Vertebrae - injuries; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; Middle Aged; Orthopedic Procedures - adverse effects; Orthopedic Procedures - methods; Prostheses and Implants - adverse effects; Spinal Fractures - surgery; Spine - diagnostic imaging; Spine - surgery; Thoracic Vertebrae - drug effects; Thoracic Vertebrae - injuries; Thoracic Vertebrae - surgery
• ISSN: 1528-1159
• DOI: 10.1097/00007632-200203010-00021

A human cadaveric model was used to evaluate balloon vertebroplasty in traumatic vertebral fractures. To assess the feasibility and safety of balloon vertebroplasty followed by calcium phosphate cement augmentation to prevent recurrent kyphosis. Failure after short-segment pedicle-screw fixation for the treatment of vertebral fractures is probably caused by a redistribution of disc material through the fractured endplate into the vertebral body, causing a decrease in anterior column support. This lack of support can give rise to instrument breakage and recurrent kyphosis after removal of the instrumentation. Restoration of the endplate morphology could prevent these events. Twenty-three traumatic fractures of thoracolumbar vertebrae were created. All fractures were distracted and fixated with short-segment pedicle screws and rods. Transpedicularly introduced inflatable bone tamps and subsequent injection of calcium phosphate cement were used to restore the endplates. Quantitative analyses of magnetic resonance images obtained at three time points were used to evaluate the morphology of the vertebral body and disc-space. After slicing all specimens, macroscopical examination was performed to detect leakage of cement or bone displacement in undesired directions. No technical problems were encountered during the study. The balloon vertebroplasty resulted in a significant (P = 0.0014) decrease of cranial endplate impression. No cement leakage or undesired bone displacement could be detected radiologically or macroscopically. The present study suggests that balloon vertebroplasty may be a safe and feasible procedure for the restoration of traumatic thoracolumbar vertebral fractures.