ArticleCureus2023
Combined Vertebral Augmentation for Vertebral Body Fracture With Contraindications for Traditional Techniques.
Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors at 1 institution in 1 country.
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Abstract
INTRODUCTION AND
objectiveA vertebral compression fracture (VCF) can be found in trauma, osteoporosis, and tumor pathology. The most frequent is the pathological fracture in osteoporotic vertebrae in the elderly. Percutaneous techniques of vertebral cementation allow treatment of A1-A2 AO spine fractures, improving pain control and spine stabilization and decreasing mobility and mortality. Traditionally, the selection of patients is fundamental for spine surgery success, with an absolute contraindication being posterior wall involvement (A3-A4 AO spine fractures) or VCF with a loss of height greater than 50%. In this report, we present a variant surgical technique combining percutaneous spine surgery with cementoplasty for patients with classical spine surgery contraindications.
methodsFive patients with complex symptomatic VCF or A3-A4 AO spine fractures in pathologic bone with MRI short tau inversion recovery (STIR) sequence (+) were operated on with a combined technique (percutaneous kyphoplasty (KP) and vesselplasty). The visual analog scale
resultsThe procedure was performed within 60 days of the fracture in all patients. The mean hospital stay was two days. No patient developed major complications. All the patients had a satisfactory clinical (improvement in pain control) and radiological response at the perioperative period and at a 30-day follow-up.
conclusionsThe combined percutaneous technique allows surgical resolution of cases previously considered contraindicated, especially in elderly patients and those with comorbidities, without involving higher cost, complications, surgical time, and hospital stay. We suggest a novel, safe, and effective variation of the vertebral cementoplasty technique.
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