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Balloon vertebroplasty in combination with pedicle screw instrumentation: a novel technique to treat thoracic and lumbar burst fractures.

Abstract：

STUDY DESIGN:Clinical trial (phase II). OBJECTIVES:To assess the feasibility and safety of balloon vertebroplasty after posterior short-segment reduction and fixation for the treatment of traumatic burst fractures. SUMMARY OF BACKGROUND DATA:Hardware failure and loss of reduction after posterior short-segment instrumentation are complications caused by insufficiency of anterior column support. This is due to migration of disc tissue through the endplate into the fractured vertebral body that cannot be restored with posterior instrumentation. METHODS:Patients with traumatic thoracolumbar burst fractures without neurologic deficits were included. After posterior reduction and fixation, bilateral transpedicular balloon reduction of the endplate was performed, and calcium phosphate cement was injected. Preoperative and postoperative Cobb angle and central and anterior height were assessed with radiographs and MRI. RESULTS:Twenty patients underwent surgery without technical difficulties, 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 78 and 91% of the estimated intact height, respectively. Complications were cement leakage in five cases without clinical implications and one wound hematoma. CONCLUSIONS:Transpedicular balloon vertebroplasty for the direct restoration of burst fractures seems feasible in combination with posterior instrumentation. Cement leakage occurred but had no clinical consequences.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Verlaan JJ,Dhert WJ,Verbout AJ,Oner FC

doi

10.1097/01.brs.0000152162.64015.fb

keywords:

subject

Has Abstract

pub_date

2005-02-01 00:00:00

pages

E73-9

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-200502010-00023

journal_volume

pub_type

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Balloon vertebroplasty in combination with pedicle screw instrumentation: a novel technique to treat thoracic and lumbar burst fractures.