title: Vertebroplasty plus short segment pedicle screw fixation in a burst fracture model in cadaveric spines.
abstract: The current project investigates the role of vertebroplasty in supplementing short segment (SS) posterior instrumentation, only one level above and below a fracture. In the treatment of thoracolumbar burst fractures, long segment (LS) posterior instrumentation two levels above and below the fracture level has been used. In our study, burst fractures were produced at L1 in eight fresh frozen human cadaveric spines. The spines were then tested in three conditions: 1) intact, 2) after LS (T11-L3), 3) SS (T12-L2) instrumentation with pedicle screws and rods, and 4) short segment instrumentation plus cement augmentation of the fracture level (SSC). LS instrumentation was found to significantly reduce the motion at the instrumented level (T12-L2) as well as the levels immediately adjacent in flexion, extension and lateral bending. Similarly, SSC augmentation was found to significantly reduce the motion compared to intact at T12-L2 but still maintained the adjacent level motion. However, SS instrumentation alone did not significantly reduce the motion at T12-L2 except for left lateral bending. While LS instrumentation remains the most stable construct, SS instrumentation augmented with vertebroplasty at the fracture level increases rigidity in flexion, extension and right lateral bending beyond SS instrumentation alone.
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, 1826 JPP, Iowa City, IA 52242, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Grossbach
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, 1826 JPP, Iowa City, IA 52242, USA.
authors.forename: Stephanus V
authors.initials: SV
authors.lastname: Viljoen
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, 1826 JPP, Iowa City, IA 52242, USA. Electronic address: patrick-hitchon@uiowa.edu.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Hitchon
authors.affiliation: Center for Computer Aided Design, The University of Iowa, Iowa City, IA, USA.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: DeVries Watson
authors.affiliation: Center for Computer Aided Design, The University of Iowa, Iowa City, IA, USA; Department of Biomedical Engineering, The University of Iowa, Iowa City, IA, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Grosland
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, 1826 JPP, Iowa City, IA 52242, USA; Department of Epidemiology, The University of Iowa, Iowa City, IA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Torner
mesh_terms: D001696:Biomechanical Phenomena; D001843:Bone Cements; D002102:Cadaver; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery*; D009127:Muscle Rigidity; D065289:Pedicle Screws; D011859:Radiography; D016059:Range of Motion, Articular; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery*; D054854:Vertebroplasty / Q000295:instrumentation* / Q000379:methods
chemical_list: D001843:Bone Cements
keywords: Kyphoplasty; Spine biomechanics; Vertebral compression fractures; Vertebroplasty