New perspective for third generation percutaneous vertebral augmentation procedures

Clinical Studies

New perspective for third generation percutaneous vertebral augmentation procedures

Clinical Studies

New perspective for third generation percutaneous vertebral augmentation procedures: Preliminary results at 12 months. J Craniovertebr Junction Spine 2012 Jul;3(2):47-51.

Vanni D, Pantalone A, Bigossi F, Pineto F, Lucantoni D, Salini V.

 

Conclusion:

 

Abstract

Introduction

 

The prevalence of osteoporotic vertebral fractures (OVF) increased in the last years. Compression fractures promote a progressive spine kyphosis increase, resulting in a weight shift and anterior column overload, with OVF additional risk (domino effect). The aim of this study is to evaluate the OVF treatment outcome using Spine Jack ®, a titanium device for third generation percutaneous vertebral augmentation procedures (PVAPs).

 

Materials and Methods

 

From February 2010, a prospective randomized study was performed examining 300 patients who underwent PVAP due to OVF type A1 according to Magerl/AO spine classification. Patients enrolled in the study were divided in two homogenous groups with regards to age (65-85 years), sex, and general clinical findings. Group A included 150 patients who underwent PVAP using Spine Jack ® system; the second, group B (control group), included 150 patients treated by conventional balloon kyphoplasty. Patients underwent a clinical (visual analogue scale and Oswestry disability index) and radiographic follow-up, with post-operative standing plain radiogram of the spine at 1, 6, and 12 months. The radiographic parameters that were taken into account were: Post-operative anterior vertebral body height, pre-operative anterior vertebral body height, cephalic anterior vertebral body height, and caudal anterior vertebral body height.

 

Results

 

Compared to the Spine Jack ® group, the kyphoplasty group required a little longer operation time (an average of 40 min-group A vs. 45 min-group B, P < 0.05) and a greater amount of polymethylmethacrylate (4.0 mL-group A vs. 5.0 mL-group B, P < 0.05;). The post-operative increase in vertebral body height was greater in the Spine Jack ® group than in the kyphoplasty group (P < 0.05).

 

Discussion

PVAP are based on the cement injection into the vertebral body. Vertebroplasty does not allow the vertebral body height recovery. Balloon kyphoplasty allows a temporary height restoration. Spine Jack ® has some new features compared to other systems: It is equipped with a mechanical and not a hydraulic opening control; this ensures a gradual and controlled vertebral fracture reduction.

 

Conclusions

 

In our study, we demonstrated that the third generation PVAP with Spine Jack ® is able to determine a safe vertebral body height restoration compared to the conventional balloon kyphoplasty.

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