Devoted to diagnostic and interventional spine imaging and therapeutics


Vertebral Augmentation With Titanium T6-Endoprosthesis: A Preliminary Experience 2014

Category Interventional Emanuele Piras
Stefano Marini
Stefano Marcia
Purpose The aim of this study was to evaluate the effectiveness of titanium vertebral augmentation system in the treatment of vertebral compressive fractures by means of pain reduction and height reastauration. Materials & Methods Eighteen consecutive patients (6 male, 12 female, average age: 69,7) with painful vertebral compressive fractures underwent titanium vertebral augmentation system. Patients had been previously evaluated with clinical examination and with X-Ray, CTms and MRI T2w STIR. All the procedures were executed with local anaesthesia and bilateral approach under digital fluoroscopic guidance. After the working cannulas were inserted, two titanium implants were expanded within the vertebral body; bone cement (PMMA) was then injected under fluoroscopic control. A total of 20 vertebras was treated. Clinical evaluation, assessment of pain by mean of a 11-points visual analogue scale (VAS, 0-10) and of function by means of the Oswestry disability scale (ODI 0-100%) was performed at baseline and at one month after the procedure. Height restauration by mean of volume calculation with CTms was made before and after the procedure. Results We have obtained a progressive reduction of the pain in all the patients (Av. VAS pre: 8.1, post 2.9, difference: 5.2), an improvement of function (ODI baseline: 54%, at 1M: 25%, difference: 29%) a good restoring of the height (Av. h pre: 11.6 mm, post: 16.3 mm, difference: 4.7 mm), and a good increasing of the volume of the vertebral bodies (Av. V pre: 12.82 cm3, post: 20.56 cm3, difference: 7.74 cm3). No complications arose, neither device migration was noted. Conclusion From our preliminary studies the implant of vertebral augmentation with titanium t6-endoprosthesis resulted to be safe and effective in the treatment of painful vertebral compressive fractures. References 1. Position Statement on Percutaneous Vertebral Augmentation: A Consensus Statement Developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and Society of NeuroInterventional Surgery (SNIS). 2013. 2. Clinical and Radiological Results Six Years after Treatment of Traumatic Thoracolumbar Burst Fractures with Pedicle Screw Instrumentation and Balloon Assisted Endplate Reduction. 2013. 3. Survival and Cost Comparison of Kyphoplasty and Percutaneous Vertebroplasty Using German Claims Data. 2013. 4. Cluster phenomenon of vertebral refractures after percutaneous vertebroplasty in a patient with glucocorticosteroid-induced osteoporosis: case report and review of the literature. 2013;38(25):E1628–32. 5. Use of vertebroplasty to prevent proximal junctional fractures in adult deformity surgery: a biomechanical cadaveric study. 2013;13(12):1897–1903. 6. Cement-augmented anterior screw fixation of Type II odontoid fractures in elderly patients with osteoporosis. 2013;13(12):1858–1863. 7. Surgical treatment of cervical vertebral hemangioma associated with adjacent cervical spondylotic myelopathy. 2013;13(12):1774–1779. 8. Infection after vertebroplasty or kyphoplasty. A series of nine cases and review of literature. 2013;13(12):1809–1817. 9. Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades. 2013;22(12):2695–2701. 10. Vertebral augmentation in the treatment of pathologic compression fractures in 792 patients with multiple myeloma. 2013;27(12):2391–2393.