gms | German Medical Science

Objective: We present the surgical technique and patient data of96 patients with two years follow up treated for osteoporotic, traumatic and metastatic compression fractures of the thoracic and lumbar spine. Patient data were collected prospectively. The aim of this study is to evaluate the restoration of sagittal balance with this technique and the clinical outcome for the patients.

Methods: We treated 96 patients for106spinal fractures with an age ranging from 26-87 years. Fractures weretraumatic (76),osteoporotic (17) and metastatic (3). Magerl classification was type A.1.1 (4), A.1.2 (23) A.1.3 (8), A.2.1 (4), A.2.2. (1), A.2.3 (15), A.3.1 (19), A.3.2 (20) und A.3.3 (12). All implants were percutaneous and transpedicular. For augmentation PMMA or a combination of PMMA / hydroxyapatite was used. All patients had a preop clinical examination, spine x-ray, CT and MRI as well as a postop clinical examination and x-ray after mobilization. For each patient we measured the height of the vertebral body as well as the kyphosis angle of the fractured vertebral body. Restoration of the spinal profiles was assessed with spine x-ray. All included patients had a 2 year follow up.

Results: Within the 2 years follow-up period, the reduction of pain according to VA-scale was 77%. Increase of vertebral body height was 15% after the procedure and 11% after 1 year. The kyphosis angle was -6° prior to surgery and -4° 2 year later. The restoration of the sagittal balance was detectable in 87% of the cases. Cement leak was seen in40cases (41,7%), in all of them without neurologic deficit. The was no reoperation in the same segment within 2 years.

Conclusion: The presented method with a craniocaudal expandable implant is efficient and is providing excellent results after 2 years follow up. This technique allows a restoration of sagittal balance in most cases. We achieved long lasting reduction of pain and pain medication in our patients.