Reinforcement of Thoracolumbar Burst Fractures With Calcium Phosphate Cement

Mermelstein, Laurence E.; McLain, Robert F.; Yerby, Scott A.

doi:10.1097/00007632-199803150-00004

Cited by 145 publications

(68 citation statements)

References 35 publications

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“…Several studies have been conducted to assess the strength and stiffness of vertebral compression fractures after vertebroplasty with polymethyl methacrylate cement and CPC [27][28][29][30][31]40]. In the cadaveric biomechanical study by Mermelstein et al they found that the injection of CPC in a burst fracture reduced the load on the pedicle screw construct that was inserted for fracture stabilization [32].…”

Section: Discussionmentioning

confidence: 99%

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Afzal¹,

Saleem²,

Dhar³

2008

Eur Spine J

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To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The postoperative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit.

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Section: Discussionmentioning

confidence: 99%

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Afzal¹,

Saleem²,

Dhar³

2008

Eur Spine J

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show abstract

“…It is known that cement-based vertebroplasty can restore, even increase, strength and stiffness after VCFs in osteoporotic specimens. 2,3,5 In a cadaveric biomechanical study by Mermelstein et al, the authors found that the injection of cement into a burst fracture reduced the load on the pedicle screw construct that was inserted for fracture stabilization, 17 and cement-based vertebroplasty after insertion of posterior instrumentation might reduce hardware failure and anterior column collapse. This conclusion was also supported by the results of our study in which there is no hardware failure in any patient during follow-up after instrumentation insertion and PVP, although the mean age in the patient population was 73.6 years.…”

Section: Disclosurementioning

confidence: 99%

Letter to the Editor: Oswestry Disability Index

Fairbank¹

2014

SPI

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“…Considering their properties, CPC might potentially be used to reinforce osteoporotic vertebral bodies [4,44] and thoracolumbar burst fractures [33] and to restore pedicle screw fixation [36]. Despite encouraging results, surgeons' expectations have not been met.…”

Section: Calcium Phosphate Cementsmentioning

confidence: 99%