Laurent Huwart1, Pauline Foti2, Olivier Andreani3, Olivier Hauger4, Elodie Cervantes5, Philippe Brunner6, Pascal Boileau7, Nicolas Amoretti8. 1. Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: huwart.laurent@wanadoo.fr. 2. Department of Biostatistics, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: pfoti@hotmail.fr. 3. Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: andreani.olivier@gmail.com. 4. Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France. Electronic address: olivier.hauger@chubordeaux.fr. 5. Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: elodie.cervantes@live.fr. 6. Department of Radiology, Hôpital Princesse Grasse de Monaco, Monaco. Electronic address: pbrunner@chpg.mc. 7. Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: boileau.p@chu-nice.fr. 8. Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: amorettinicolas@yahoo.fr.
Abstract
OBJECTIVE: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. RESULTS: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P<0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P<0.001). CONCLUSION: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.
OBJECTIVE: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. RESULTS: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P<0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P<0.001). CONCLUSION: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.
Authors: Marc Auerswald; Philipp Messer-Hannemann; Kay Sellenschloh; Jan Wahlefeld; Klaus Püschel; Sven Hirschfeld Araujo; Michael M Morlock; Arndt P Schulz; Gerd Huber Journal: Global Spine J Date: 2020-08-03