Current Concepts in the Management of Vertebral Compression Fractures

Hoyt, Dylan; Urits, Ivan; Orhurhu, Vwaire; Orhurhu, Mariam Salisu; Callan, Jessica; Powell, Jordan; Manchikanti, Laxmaiah; Kaye, Alan D.; Viswanath, Omar

doi:10.1007/s11916-020-00849-9

Cited by 78 publications

(53 citation statements)

References 70 publications

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“…The quantity of cement injected would have been an interesting data to correlate to the loss of correction. The lack of clinical data is regrettable, but clinical results seems to correlate with sagittal angulation in spinal fractures, at early as well as in long-term perspective [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Efficiency of a Novel Vertebral Body Augmentation System (Tektona™) in Non-osteoporotic Spinal Fractures

Marie-Hardy

Mohsinaly

Pietton

et al. 2021

Preprint

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BackgroundThe restauration of the local kyphosis is crucial for spinal fractures outcomes. Recently, the Tektona™, (Spine Art) system, constituted by a flexible lamella for reduction has emerged as a promising solution for osteoporotic fractures. However, no study has yet focused on its results on traumatic fractures. MethodsA retrospective longitudinal study on prospectively collected data was conducted on 53 patients. The data collected were clinical, surgical and scannographic (measurement of AVH, MVH and PVH (anterior/medium/posterior vertebral height), and RTA (regional traumatic angle) in°), preoperatively, early post-operative and at follow-up. ResultsFractures were mainly located at the upper lumbar spine and were Magerl A3.1 type for 51%. The mean RTA was 12° in pre-operative, 4° in post-operative (p=2e-9), and 8° at the last follow-up (p=0,01). The mean correction of RTA for the fixation group was -10±6° versus -7±4° for the vertebroplasty alone group (p=0,006). The mean correction for fractures located at T10-T12 was -9±3°, -9±5° for L1, -8±3° for L2 and -5±3° for L3-L5 (p=0,045). ConclusionsThe Tektona® system appears to be efficient for acute thoraco-lumbar fractures, comparable to other available systems, allowing a real intracorporeal reduction work. Its relevance, especially in the long term needs further investigation. The association of a percutaneous fixation allow to obtain a better correction of the RTA but did not seem to prevent the loss of correction at follow-up.

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Section: Discussionmentioning

confidence: 99%

Efficiency of a Novel Vertebral Body Augmentation System (Tektona™) in Non-osteoporotic Spinal Fractures

Marie-Hardy

Mohsinaly

Pietton

et al. 2021

Preprint

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“…Vertebral fractures often cause acute or chronic pain. In severe cases, they can cause kyphosis, which can limit daily activities and reduce quality of life [8,9]. In the most serious case, it can be paralysis or even life-threatening, placing a heavy financial burden on the families of the patients [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Clinical Observation of Intraosseous Anesthesia in Percutaneous Kyphoplasty

Bao

Wang

et al. 2021

Journal of Healthcare Engineering

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Objective. Percutaneous kyphoplasty (PKP) is an effective minimally invasive technique in spine surgery in recent years. General anesthesia and local anesthesia are the main ways of anesthesia in PKP, and epidural anesthesia is also applied to PKP to some extent. However, all these three anesthetic methods have their respective advantages and disadvantages. It is essential to compare and evaluate the effects of different anesthesia methods on PKP for treating spinal fractures. Method. A total of 45 patients (53 vertebral bodies were included) were divided into two groups. Group A included 24 patients (29 vertebral bodies) with an average of 71 years old and Group B included 21 patients (24 vertebral bodies) with an average of 74 years old. Visual analogue scale (VAS) scores were recorded preoperatively; balloon expansion and bone cement injection were conducted intraoperatively. Then, they were recorded immediately after operation, 6 h postoperatively, to assess the pain level of the patient. Moreover, hospitalization time (days), operation duration (minutes), and bone cement injection amount (mL) had also been recorded. Results. There was no significant difference in preoperative general information and VAS score. However, the VAS scores were statistically significant at both the moment of balloon expansion and injection of bone cement. At the moment of immediate postoperation, the VAS scores showed no statistically significant difference, while it showed a statistically significant difference 6 h postoperatively. Conclusion. The anesthesia method by injection of 1% lidocaine hydrochloride (5 ml) into vertebral body can effectively relieve patients’ pain in intraoperation and postoperation.

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“…A compression fracture is a fracture of the vertebrae that results in a reduction in the height of the vertebrae by at least 20%. Vertebral compression fractures often occur at the midthoracic (T7–T8) spine and the thoracolumbar junction (T12–L1) [ 13 , 14 ]. The clinical treatment of vertebral compression fractures includes conservative treatment (such as physical therapy and spinal orthosis), vertebroplasty (such as minimally invasive percutaneous vertebroplasty and kyphoplasty) and vertebral implantation (such as SpineJack® and Vertebral Body Stent®) [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Structural geometries and mechanical properties of vertebral implant with honeycomb sandwich structure for vertebral compression fractures: a finite element analysis

et al. 2021

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Background Because of osteoporosis, traffic accidents, falling from high places, and other reasons, the vertebral body can be compressed and even collapse. Vertebral implants can be used for clinical treatment. Because of the advantages of honeycomb sandwich structures, such as low cost, less material, light weight, high strength, and good cushioning performance. In this paper, the honeycomb sandwich structure was used as the basic structure of vertebral implants. Methods The orthogonal experiment method is applied to analyse the size effect of honeycomb sandwich structures by the finite element method. Based on the minimum requirements of three indexes of peak stress, axial deformation, and anterior–posterior deformation, the optimal structure size was determined. Furthermore, through local optimization of the overall structure of the implant, a better honeycomb sandwich structure vertebral implant was designed. Results The optimal structure size combination was determined as a panel thickness of 1 mm, wall thickness if 0.49 mm, cell side length of 1 mm, and height of 6 mm. Through local optimization, the peak stress was further reduced, the overall stress distribution was uniform, and the deformation was reduced. The optimized peak stress decreased to 1.041 MPa, the axial deformation was 0.1110%, and the anterior–posterior deformation was 0.0145%. A vertebral implant with good mechanical performance was designed. Conclusions This paper is the first to investigate vertebral implants with honeycomb sandwich structures. The design and analysis of the vertebral implant with a honeycomb sandwich structure were processed by the finite element method. This research can provide a feasible way to analyse and design clinical implants based on biomechanical principles.

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Current Concepts in the Management of Vertebral Compression Fractures

Cited by 78 publications

References 70 publications

Efficiency of a Novel Vertebral Body Augmentation System (Tektona™) in Non-osteoporotic Spinal Fractures

Efficiency of a Novel Vertebral Body Augmentation System (Tektona™) in Non-osteoporotic Spinal Fractures

Clinical Observation of Intraosseous Anesthesia in Percutaneous Kyphoplasty

Structural geometries and mechanical properties of vertebral implant with honeycomb sandwich structure for vertebral compression fractures: a finite element analysis

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