[Vertebral body stenting. A method for repositioning and augmenting vertebral compression fractures].
Purpose of the study was to demonstrate the effectiveness of expanding a fractured vertebral body by transpedicular dilatation and stenting. 7 human cadaveric vertebral bodies from L2 to L5 underwent axia compression until a vertebral burst fracture was provoked. Then, by bilateral transpedicular approach, balloon-catheters were introduced, which were armed with stents, usually used for angioplasty. The catheters were inflated with radiolucent fluid and the stents expanded under radiologic control. After expansion, the balloon was deflated and removed, the stents resting inside the vertebral body, holding their inflated shape. Then, the resulting hole was filled with an injectable biodegradable calcium-phosphate. CT-scans were performed after destruction and after expansion. Morphology before and after expansion was judged, using 3-D reconstructions. Vertebral body strength was measured before destruction and after treatment with an Instron testing machine.


RESULTS
Vertebral body shape could be restored. Also impressed central parts of the bony endplate could be elevated by using a convergent approach through the pedicles. There was no collapse of the vertebral body after removing the catheter-balloons The vertebral body strength could be restored up to a physiologic level. This procedure gives new perspectives in the treatment either of osteoporotic compression or traumatic vertebral fracture. By using CT-guided technique, it could be performed by a minimally invasive approach percutaneously.
Fürderer
S
S
Klinik und Poliklinik für Orthopädie, Universität zu Köln, Josef Stelzmann Str. 3, 50924 Köln. Sebastian.fuerderer@medizin.uni-koeln.de
Anders
M
M
Schwindling
B
B
Salick
M
M
Düber
C
C
Wenda
K
K
Urban
R
R
Glück
M
M
Eysel
P
P
D000368:Aged; D018786:Bone Substitutes; D002130:Calcium Phosphates / Q000008:administration & dosage; D002404:Catheterization / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000601:surgery; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed
D018786:Bone Substitutes; D002130:Calcium Phosphates; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; C485838:calcium phosphate, monobasic, anhydrous; C020243:calcium phosphate; C485829:calcium phosphate, dibasic, anhydrous
Vertebral body stenting. Eine Methode zur Reposition und Augmentation von Wirbelkörperkompressionsfrakturen.