Antonio Krüger1, Martin Bäumlein2, Tom Knauf2, Hugues Pascal-Moussellard3, Steffen Ruchholtz2, Ludwig Oberkircher4. 1. Department of Trauma Surgery, Orthopaedic Surgery and Spine Surgery, Asklepios Hospital Lich GmbH, Lich, Germany. 2. Center for Orthopaedics and Trauma Surgery, Philipps University Marburg, Baldingerstraße, 35043, Marburg, Germany. 3. Pitié- Salpêtrière Hospital, Université Pierre et Marie Curie - Paris VI, Orthopaedic dpt, Paris, France. 4. Center for Orthopaedics and Trauma Surgery, Philipps University Marburg, Baldingerstraße, 35043, Marburg, Germany. oberkirc@med.uni-marburg.de.
Abstract
BACKGROUND: Standard balloon kyphoplasty represents a well-established treatment option for osteoporotic vertebral compression fractures. Aim of the present study was to evaluate two different methods of percutaneous augmentation (standard balloon kyphoplasty (BKP) versus Tektona® (TEK)) with respect to height restoration. METHODS: Four-teen vertebral bodies of two female cadavers were examined. Fractures were created using a standardized protocol. CT-scans were taken before and after fracture, as well as after treatment. Afterwards two groups were randomly assigned in a matched pair design: 7 vertebral bodies (VB) were treated with BKP (Kyphon, Medtronic) and 7 vertebral bodies by TEK (Spineart, Switzerland) Anterior, central and posterior vertebral body heights were evaluated by CT-scans. Volumetry was performed using the CT-scans at three different timepoints. RESULTS: Values before fracture represent 100%. The anterior height after fracture was reduced to 75.99 (± 4.8) % for the BKP group and to 76.54 (± 9.17) % in the TEK Group. Statistically there was no difference for the groups (p = 1). After treatment the values increased to 93.06 (± 5) % for the BKP Group and 87.71 (± 6.2) % for the TEK Group. The difference before and after treatment was significant for both groups (BKP p = 0.0006; TEK p = 0.03). Within the groups, there was no difference (p = 0.13). The Volume of the vertebral body was reduced to 82.29 (± 8.4) % in the BKP Group and to 76.54 (± 8.6) % in the TEK Group. After treatment the volume was 89.26 (± 6.9) % for the BKP Group and 88.80 (± 8.7) % for the TEK Group. The difference before and after treatment was significant only for the TEK group (BKP p = 0.0728 n.s.; TEK p = 0.0175). Within the groups, there was no difference (p = 0.2). The average cement volume used was 6.1 (range 3.6-9 ml) for the BKP group and 5.3 (3-7.2 ml) for the TEK group respectively. CONCLUSIONS: Based on our results the new System Tektona® in osteoporotic compression fractures might represent a promising alternative for the clinical setting, especially preserving bone. Further biomechanical tests and clinical studies have to proof Tektona®`s capabilities.
RCT Entities:
BACKGROUND: Standard balloon kyphoplasty represents a well-established treatment option for osteoporotic vertebral compression fractures. Aim of the present study was to evaluate two different methods of percutaneous augmentation (standard balloon kyphoplasty (BKP) versus Tektona® (TEK)) with respect to height restoration. METHODS: Four-teen vertebral bodies of two female cadavers were examined. Fractures were created using a standardized protocol. CT-scans were taken before and after fracture, as well as after treatment. Afterwards two groups were randomly assigned in a matched pair design: 7 vertebral bodies (VB) were treated with BKP (Kyphon, Medtronic) and 7 vertebral bodies by TEK (Spineart, Switzerland) Anterior, central and posterior vertebral body heights were evaluated by CT-scans. Volumetry was performed using the CT-scans at three different timepoints. RESULTS: Values before fracture represent 100%. The anterior height after fracture was reduced to 75.99 (± 4.8) % for the BKP group and to 76.54 (± 9.17) % in the TEK Group. Statistically there was no difference for the groups (p = 1). After treatment the values increased to 93.06 (± 5) % for the BKP Group and 87.71 (± 6.2) % for the TEK Group. The difference before and after treatment was significant for both groups (BKP p = 0.0006; TEK p = 0.03). Within the groups, there was no difference (p = 0.13). The Volume of the vertebral body was reduced to 82.29 (± 8.4) % in the BKP Group and to 76.54 (± 8.6) % in the TEK Group. After treatment the volume was 89.26 (± 6.9) % for the BKP Group and 88.80 (± 8.7) % for the TEK Group. The difference before and after treatment was significant only for the TEK group (BKP p = 0.0728 n.s.; TEK p = 0.0175). Within the groups, there was no difference (p = 0.2). The average cement volume used was 6.1 (range 3.6-9 ml) for the BKP group and 5.3 (3-7.2 ml) for the TEK group respectively. CONCLUSIONS: Based on our results the new System Tektona® in osteoporotic compression fractures might represent a promising alternative for the clinical setting, especially preserving bone. Further biomechanical tests and clinical studies have to proof Tektona®`s capabilities.
Entities:
Keywords:
Biomechanical; Cement; Compression fracture; Osteoporosis; Vertebral body fracture
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