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Radiographic and safety details of vertebral body stenting: results from a multicenter chart review

Identifieur interne : 000498 ( Main/Exploration ); précédent : 000497; suivant : 000499

Radiographic and safety details of vertebral body stenting: results from a multicenter chart review

Auteurs : Peter Diel [Suisse, Allemagne] ; Christoph Röder [Suisse] ; Gosia Perler [Suisse] ; Thomas Vordemvenne [Allemagne] ; Matti Scholz [Allemagne] ; Frank Kandziora [Allemagne] ; Sebastian Fürderer [Allemagne] ; Soren Eiskjaer [Danemark] ; Gianluca Maestretti [Suisse] ; Robert Rotter [Allemagne] ; Lorin Michael Benneker [Suisse] ; Paul Friedhelm Heini [Suisse]

Source :

RBID : PMC:3751159

Abstract

Background

Up to one third of BKP treated cases shows no appreciable height restoration due to loss of both restored height and kyphotic realignment after balloon deflation. This shortcoming has called for an improved method that maintains the height and realignment reached by the fully inflated balloon until stabilization of the vertebral body by PMMA-based cementation. Restoration of the physiological vertebral body height for pain relief and for preventing further fractures of adjacent and distant vertebral bodies must be the main aim for such a method. A new vertebral body stenting system (VBS) stabilizes the vertebral body after balloon deflation until cementation. The radiographic and safety results of the first 100 cases where VBS was applied are presented.

Methods

During the planning phase of an ongoing international multicenter RCT, radiographic, procedural and followup details were retrospectively transcribed from charts and xrays for developing and testing the case report forms. Radiographs were centrally assessed at the institution of the first/senior author.

Results

100 patients (62 with osteoporosis) with a total of 103 fractured vertebral bodies were treated with the VBS system. 49 were females with a mean age of 73.2 years; males were 66.7 years old. The mean preoperative anterior-middle-posterior heights were 20.3-17.6-28.0 mm, respectively. The mean local kyphotic angle was 13.1°. The mean preoperative Beck Index (anterior edge height/posterior edge height) was 0.73, the mean alternative Beck Index (middle height/posterior edge height) was 0.63. The mean postoperative heights were restored to 24.5-24.6-30.4 mm, respectively. The mean local kyphotic angle was reduced to 8.9°. The mean postoperative Beck Index was 0.81, the mean alternative one was 0.82. The overall extrusion rate was 29.1%, the symptomatic one was 1%. In the osteoporosis subgroup there were 23.8% extrusions. Within the three months followup interval there were 9% of adjacent and 4% of remote new fractures, all in the osteoporotic group.

Conclusions

VBS showed its strengths especially in realignment of crush and biconcave fractures. Given that fracture mobility is present, the realignment potential is sound and increases with the severity of preoperative vertebral body deformation.


Url:
DOI: 10.1186/1471-2474-14-233
PubMed: 23927056
PubMed Central: 3751159


Affiliations:


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<name sortKey="Rotter, Robert" sort="Rotter, Robert" uniqKey="Rotter R" first="Robert" last="Rotter">Robert Rotter</name>
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<sec>
<title>Background</title>
<p>Up to one third of BKP treated cases shows no appreciable height restoration due to loss of both restored height and kyphotic realignment after balloon deflation. This shortcoming has called for an improved method that maintains the height and realignment reached by the fully inflated balloon until stabilization of the vertebral body by PMMA-based cementation. Restoration of the physiological vertebral body height for pain relief and for preventing further fractures of adjacent and distant vertebral bodies must be the main aim for such a method. A new vertebral body stenting system (VBS) stabilizes the vertebral body after balloon deflation until cementation. The radiographic and safety results of the first 100 cases where VBS was applied are presented.</p>
</sec>
<sec>
<title>Methods</title>
<p>During the planning phase of an ongoing international multicenter RCT, radiographic, procedural and followup details were retrospectively transcribed from charts and xrays for developing and testing the case report forms. Radiographs were centrally assessed at the institution of the first/senior author.</p>
</sec>
<sec>
<title>Results</title>
<p>100 patients (62 with osteoporosis) with a total of 103 fractured vertebral bodies were treated with the VBS system. 49 were females with a mean age of 73.2 years; males were 66.7 years old. The mean preoperative anterior-middle-posterior heights were 20.3-17.6-28.0 mm, respectively. The mean local kyphotic angle was 13.1°. The mean preoperative Beck Index (anterior edge height/posterior edge height) was 0.73, the mean alternative Beck Index (middle height/posterior edge height) was 0.63. The mean postoperative heights were restored to 24.5-24.6-30.4 mm, respectively. The mean local kyphotic angle was reduced to 8.9°. The mean postoperative Beck Index was 0.81, the mean alternative one was 0.82. The overall extrusion rate was 29.1%, the symptomatic one was 1%. In the osteoporosis subgroup there were 23.8% extrusions. Within the three months followup interval there were 9% of adjacent and 4% of remote new fractures, all in the osteoporotic group.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>VBS showed its strengths especially in realignment of crush and biconcave fractures. Given that fracture mobility is present, the realignment potential is sound and increases with the severity of preoperative vertebral body deformation.</p>
</sec>
</div>
</front>
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</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Danemark</li>
<li>Suisse</li>
</country>
<region>
<li>Canton de Berne</li>
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<orgName>
<li>Université de Berne</li>
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</list>
<tree>
<country name="Suisse">
<region name="Canton de Berne">
<name sortKey="Diel, Peter" sort="Diel, Peter" uniqKey="Diel P" first="Peter" last="Diel">Peter Diel</name>
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<name sortKey="Heini, Paul Friedhelm" sort="Heini, Paul Friedhelm" uniqKey="Heini P" first="Paul Friedhelm" last="Heini">Paul Friedhelm Heini</name>
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<name sortKey="Maestretti, Gianluca" sort="Maestretti, Gianluca" uniqKey="Maestretti G" first="Gianluca" last="Maestretti">Gianluca Maestretti</name>
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<name sortKey="Roder, Christoph" sort="Roder, Christoph" uniqKey="Roder C" first="Christoph" last="Röder">Christoph Röder</name>
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<country name="Allemagne">
<region name="Hesse (Land)">
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<name sortKey="Furderer, Sebastian" sort="Furderer, Sebastian" uniqKey="Furderer S" first="Sebastian" last="Fürderer">Sebastian Fürderer</name>
<name sortKey="Kandziora, Frank" sort="Kandziora, Frank" uniqKey="Kandziora F" first="Frank" last="Kandziora">Frank Kandziora</name>
<name sortKey="Rotter, Robert" sort="Rotter, Robert" uniqKey="Rotter R" first="Robert" last="Rotter">Robert Rotter</name>
<name sortKey="Scholz, Matti" sort="Scholz, Matti" uniqKey="Scholz M" first="Matti" last="Scholz">Matti Scholz</name>
<name sortKey="Vordemvenne, Thomas" sort="Vordemvenne, Thomas" uniqKey="Vordemvenne T" first="Thomas" last="Vordemvenne">Thomas Vordemvenne</name>
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<country name="Danemark">
<noRegion>
<name sortKey="Eiskjaer, Soren" sort="Eiskjaer, Soren" uniqKey="Eiskjaer S" first="Soren" last="Eiskjaer">Soren Eiskjaer</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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