Julien Garnon1, Benjamin Doré2,3, Pierre Auloge2, Jean Caudrelier2, Danoob Dalili4, Nitin Ramamurthy5, Guillaume Koch2, Roberto Luigi Cazzato2, Afshin Gangi2. 1. Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France. juliengarnon@gmail.com. 2. Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France. 3. Department of Medical Imaging, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Groupe des hôpitaux universitaires Paris Ile de France Ouest, 92380, Garches, France. 4. Department of Radiology, Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK. 5. Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
Abstract
INTRODUCTION: To evaluate the effectiveness of percutaneous image-guided vertebral body stenting (VBS) at restoring vertebral height in acute, stable, traumatic thoracolumbar fractures in a young, non-osteoporotic population. MATERIALS AND METHODS: A single-centre retrospective review of all traumatic non-osteoporotic fractures treated with VBS between 2010 and 2017 was performed. Inclusion criteria included patients with recent (< 10 days), symptomatic and stable thoracolumbar compression fractures. Patients with low-energy fractures, osteoporosis and age > 60/50 years (male/female) were excluded. Primary outcomes included: correction of vertebral height, correction of kyphosis angle and Beck Index on reconstructed pre- and post-procedural CBCT images. Secondary outcomes included intra-procedural stent recoil, complications, cement leakage and factors predicting height restoration. RESULTS: Thirty-nine patients (26 men, 13 women; mean age 33.6 years, range 15-57 years) underwent VBS 5 days post-trauma on average (range 1-10), for stable compression fractures located between T5 and L5. Mean vertebral height gain, vertebral kyphosis angle correction and Beck index improvement were 3.8 mm (95% CI 3.36-4.50; P(> 3 mm) = 99.9%), 4.3° (95% CI 3.50-5.20; P(> 3°) = 99.9%) and 0.07 [95% CI 0.053-0.11], respectively (all statistically significant). Technical success was 92%, with 3 "major" stent recoils resulting in loss of vertebral height correction. No symptomatic complications were observed. No predictive factors for procedural success were identified. CONCLUSION: VBS can significantly restore vertebral height in young patients with traumatic vertebral compression fractures.
INTRODUCTION: To evaluate the effectiveness of percutaneous image-guided vertebral body stenting (VBS) at restoring vertebral height in acute, stable, traumatic thoracolumbar fractures in a young, non-osteoporotic population. MATERIALS AND METHODS: A single-centre retrospective review of all traumatic non-osteoporotic fractures treated with VBS between 2010 and 2017 was performed. Inclusion criteria included patients with recent (< 10 days), symptomatic and stable thoracolumbar compression fractures. Patients with low-energy fractures, osteoporosis and age > 60/50 years (male/female) were excluded. Primary outcomes included: correction of vertebral height, correction of kyphosis angle and Beck Index on reconstructed pre- and post-procedural CBCT images. Secondary outcomes included intra-procedural stent recoil, complications, cement leakage and factors predicting height restoration. RESULTS: Thirty-nine patients (26 men, 13 women; mean age 33.6 years, range 15-57 years) underwent VBS 5 days post-trauma on average (range 1-10), for stable compression fractures located between T5 and L5. Mean vertebral height gain, vertebral kyphosis angle correction and Beck index improvement were 3.8 mm (95% CI 3.36-4.50; P(> 3 mm) = 99.9%), 4.3° (95% CI 3.50-5.20; P(> 3°) = 99.9%) and 0.07 [95% CI 0.053-0.11], respectively (all statistically significant). Technical success was 92%, with 3 "major" stent recoils resulting in loss of vertebral height correction. No symptomatic complications were observed. No predictive factors for procedural success were identified. CONCLUSION:VBS can significantly restore vertebral height in young patients with traumatic vertebral compression fractures.
Entities:
Keywords:
Compression fractures; Stentoplasty; Vertebral body stenting; Vertebroplasty