title: The efficacy of a percutaneous expandable titanium device in anatomical reduction of vertebral compression fractures of the thoracolumbar spine.
abstract: OBJECTIVE
  To evaluate the feasibility of a minimally invasive technique using a titanium expandable device to achieve anatomical restoration of vertebral compression fractures (VCF) of the thoracolumbar spine.
  
  
  METHODS
  This prospective study included 27 patients diagnosed with VCF (Magerl classification A.1.2, A.1.3, and A.3.1) of the thoracolumbar spine treated with percutaneous cement augmentation using the SpineJack® device. The study was conducted in Valladolid University Hospital, Valladolid, Spain from January to December 2012, with a minimum one-year follow up. Preoperative evaluation included visual analogue scale (VAS) for pain, and radiological assessment of the VCF using 3-dimensional computed tomography (3D-CT) scans for measurements of vertebral heights and angles. The patients were followed at 3, 6, and 12 months with clinical VAS and radiological assessments.
  
  
  RESULTS
  The procedure was performed in 27 patients with a mean age of 55.9 ± 17.3 years, 55.6% females. All patients underwent surgery within 6 weeks from time of injury. No procedure related complications occurred. Pain measured by VAS score decreased from 7.0 preoperatively to 3.2 within 24 hours, and remained 2.2 at 3 months, 2.1 at 6 months, and 1.5 at 12-months follow-up (p&lt;0.05). Mean height restorations for the anterior was 3.56 mm, central was 2.49, and posterior vertebral was 1.28 mm, and maintained at 12-months follow-up (p=0.001).
  
  
  CONCLUSIONS
  This new percutaneous technique for VCF has shown good clinical results in pain control and the possibility to reduce both vertebral kyphosis angles and fractured endplates seen in 3D-CT scans assessment method. Further studies are needed to confirm those results on larger cohorts with long-term follow up.
authors: Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. Fax. +966 (12) 6408469. E-mail. sbaeesa@kau.edu.sa.
authors: Saleh S
authors: SS
authors: Baeesa
authors: Antonio
authors: A
authors: Krueger
authors: Francisco A
authors: FA
authors: Aragón
authors: David C
authors: DC
authors: Noriega
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014025:Titanium; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium
references: Osteoporos Int. 1998;8(3):261-7
references: 9797911
references: Lancet. 1999 Mar 13;353(9156):878-82
references: 10093980
references: J Am Acad Orthop Surg. 2004 Nov-Dec;12(6):424-35
references: 15615508
references: J Vasc Interv Radiol. 2005 Jul;16(7):973-9
references: 16002505
references: Spine (Phila Pa 1976). 2005 Aug 15;30(16):1840-5
references: 16103853
references: Osteoporos Int. 2005 Oct;16(10):1247-53
references: 15806323
references: Spine (Phila Pa 1976). 2006 Jan 1;31(1):57-64
references: 16395177
references: Med J Aust. 2006 Feb 6;184(3):113-7
references: 16460295
references: Spine (Phila Pa 1976). 2006 May 1;31(10):1113-8
references: 16648745
references: Osteoporos Int. 2006;17(6):817-26
references: 16518574
references: Eur Spine J. 2006 Aug;15(8):1255-64
references: 16311752
references: Spine (Phila Pa 1976). 2006 Aug 1;31(17):1983-2001
references: 16924218
references: Spine (Phila Pa 1976). 2006 Nov 1;31(23):2747-55
references: 17077747
references: Joint Bone Spine. 2006 Dec;73(6):610-3
references: 17118688
references: J Bone Miner Res. 2007 Mar;22(3):465-75
references: 17144789
references: J Spinal Disord Tech. 2007 May;20(3):221-5
references: 17473642
references: Clin J Pain. 2007 Jun;23(5):425-30
references: 17515741
references: Skeletal Radiol. 2008 Jan;37(1):35-42
references: 17962937
references: J Neurosurg Spine. 2008 Mar;8(3):246-54
references: 18312076
references: Spine J. 2008 May-Jun;8(3):488-97
references: 17588820
references: Eur Spine J. 2008 Nov;17(11):1522-30
references: 18795344
references: JAMA. 2009 Feb 4;301(5):513-21
references: 19190316
references: AJNR Am J Neuroradiol. 2009 Feb;30(2):227-31
references: 19001542
references: Joint Bone Spine. 2009 May;76(3):241-7
references: 19196531
references: J Bone Miner Res. 2011 Jul;26(7):1617-26
references: 21308780
references: Ann Saudi Med. 2012 Nov-Dec;32(6):637-41
references: 23396029
references: J Bone Joint Surg Am. 2013 Oct 2;95(19):1729-36
references: 24088964
references: J Bone Joint Surg Am. 2014 Jan 15;96(2):144-50
references: 24430414
references: Osteoporos Int. 1999;9(6):508-15
references: 10624458
references: Spine (Phila Pa 1976). 1999 Oct 15;24(20):2139-46
references: 10543013
references: Osteoporos Int. 2000;11(7):556-61
references: 11069188
references: J Anat. 2000 Nov;197 Pt 4:647-57
references: 11197538
references: J Bone Miner Res. 2002 Feb;17(2):185-91
references: 11811548
references: Spine (Phila Pa 1976). 2002 Jun 1;27(11):1160-7
references: 12045511
references: J Digit Imaging. 2002;15 Suppl 1:254-7
references: 12105745
references: J Bone Miner Res. 2003 Jan;18(1):24-9
references: 12510802
references: Spine (Phila Pa 1976). 2003 Nov 15;28(22):2517-21; disucssion 3
references: 14624087
references: J Bone Joint Surg Br. 1975 Nov;57(4):411
references: 1194306
references: Clin Orthop Relat Res. 1977 Oct;(128):78-92
references: 340100
references: J Bone Joint Surg Am. 1981 Jul;63(6):891-9
references: 6453878
references: Neurochirurgie. 1987;33(2):166-8
references: 3600949
references: Spine (Phila Pa 1976). 1988 Feb;13(2):173-8
references: 3406837
references: J Bone Miner Res. 1990 Jul;5(7):707-16
references: 2396497
references: Bone. 1992;13 Suppl 2:S27-31
references: 1627411
references: Spine (Phila Pa 1976). 1993 Dec;18(16):2431-7
references: 8303445
references: Bone. 1994 Jan-Feb;15(1):27-30
references: 8024847
references: Med Biol Eng Comput. 1997 Nov;35(6):611-8
references: 9538536