gms | German Medical Science

Objective: We present surgical technique and patient data of 76 patients with one year follow up treated for osteoporotic and traumatic compression fractures of the thoracic and lumbar spine. Patient data were collected prospectively. The aim of this study is to evaluate safety of the technique and the clinical outcome for the patients.

Methods: We treated 76 patients for 84 spinal fractures with an age ranging from 26-87 years (41 female, 35 male). Fractures were osteoporotic in 14 patients and traumatic in 62 patients. Magerl classification was type A.1.1 (3), A.1.2 (19) A.1.3 (6), A.2.1 (32), A.2.3 (12), A.3.1 (15), A.3.2 (16) und A.3.3 (10). Fracture localization was 48 (63%) T11L1, 12 (15%) T4T10 and 24 (32%) L2-L5. All implants were applied percutaneous transpedicular. For augmentation PMMA or a combination of PMMA / hydroxyapatite was used. All patients received preop a clinical examination, spine x-ray, CT and MRI and postop clinical examination and x-ray after mobilization. For pain evaluation we utilized the VA-scale. For each patient we measured the height of the vertebral body as well as the kyphosis angle of the fractured vertebral body. All included patients had a 1 year follow up.

Results: Within the 1 year follow up period the reduction of pain according to VA-scale was 77%. Increase of vertebral body hight was 15% after the procedure and 11% after 1 year. The kyphosis angle was -6° prior to surgery and -4° 1 year later. Cement leak was seen in 31 cases (41%), in all of them without neurologic deficit. The was no reoperation in the same segment and no implant dislocation within 1 year.

Conclusion: The presented method with a craniocaudal expandable implant is efficient, safe and is providing excellent results at 1 year follow up. We achieved long lastin reduction of pain and pain medication in our patients. The presented technique and the results are at least comparable to kyphoplasty.