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Sagittal correction after short percutaneous fixation for thoracolumbar compression fractures: comparison of the combination of SpineJack® kyphoplasty and fractured vertebra screw fixation

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Abstract

Purpose

The aim of this study was to compare two percutaneous pedicle fixations for the treatment of thoracolumbar fractures: one associating a jack kyphoplasty (SpineCut) and the other using intermediate screws (Trident).

Methods

All adult patients treated for single-level Magerl/AO type A thoracolumbar traumatic fractures in four orthopaedic departments, with SpineCut or Trident, with a one year minimum follow-up, were retrospectively included. Neurological disorders and osteoporotic fractures were not included. The following data were collected: age, sex, Magerl/AO type, type of surgery, and complications. Radiological parameters were analyzed on pre-operative CT scan, and on standing X-rays before discharge, at three months and one year post-operative: vertebral wedge angle (VWA), regional kyphosis angle (RKA), and traumatic regional angulation (TRA: difference between RKA and physiological values for each vertebra).

Results

Eighty patients were included, with 42 patients in SpineCut group and 38 in Trident group. Mean age was 41 ± 15.7 years. TRA correction did not differ between the groups: respectively 11.2 ± 8.1° in SpineCut versus 10.2 ± 9.1° in Trident group (p = 0.52). TRA loss of correction between early post-operative and three months was statistically higher in Trident group: −4 ± 5.1° versus −1.5 ± 3.8° (p = 0.03). After 3 months, TRA correction loss was comparable between the groups. Multivariate analysis demonstrated that pre-operative VWA was the only factor significantly associated with early TRA correction loss (p = 0.01). VWA correction and loss of correction did not differ significantly between the groups. No complications were observed.

Conclusion

Percutaneous pedicle fixations of traumatic thoracolumbar fractures associating jack kyphoplasty and intermediate screws are both safe and efficient techniques.

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References

  1. Magerl F, Aebi M, Gertzbein SD et al (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201. https://doi.org/10.1007/BF02221591

    Article  CAS  PubMed  Google Scholar 

  2. Meyblum J, Portella T, Coudert P et al (2020) Management of thoracolumbar fracture in France. Analysis of practices and radiologic results of a cohort of 407 thoracolumbar fractures. Orthop Traumatol Surg Res 106:1203–1207. https://doi.org/10.1016/j.otsr.2020.02.023

    Article  PubMed  Google Scholar 

  3. Wood KB, Li W, Lebl DR et al (2014) Management of thoracolumbar spine fractures. Spine J 14:145–64. https://doi.org/10.1016/j.spinee.2012.10.041

    Article  PubMed  Google Scholar 

  4. Been HD, Bouma GJ (1999) Comparison of two types of surgery for thoraco-lumbar burst fractures: combined anterior and posterior stabilisation vs. posterior instrumentation only. Acta Neurochir (Wien) 141:349–57. https://doi.org/10.1007/s007010050310

    Article  CAS  PubMed  Google Scholar 

  5. Gnanenthiran SR, Adie S, Harris IA (2012) Nonoperative versus operative treatment for thoracolumbar burst fractures without neurologic deficit: a meta-analysis. Clin Orthop Relat Res 470:567–577. https://doi.org/10.1007/s11999-011-2157-7

    Article  PubMed  Google Scholar 

  6. Wood KB, Buttermann GR, Phukan R et al (2015) Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit: a prospective randomized study with follow-up at sixteen to twenty-two years. J Bone Joint Surg Am 97:3–9. https://doi.org/10.2106/JBJS.N.00226

    Article  PubMed  Google Scholar 

  7. Linhares D, Pinto BS, Ribeiro da Silva M, et al (2020) Orthosis in thoracolumbar fractures: a systematic review and meta-analysis of randomized controlled trials. Spine (Phila Pa 1976) 45:E1523–E1531 . https://doi.org/10.1097/BRS.0000000000003655

  8. Ross PD, Lyons A, Cooper C, et al (1997) Clinical consequences of vertebral fractures. Am J Med 103. https://doi.org/10.1016/s0002-9343(97)90025-5

  9. Silvermann SL (1992) The clinical consequences of vertebral compression fracture. Bone 13:S27–S31

    Article  Google Scholar 

  10. Sun X-Y, Zhang X-N, Hai Y (2017) Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis. Eur Spine J 26:1418–1431. https://doi.org/10.1007/s00586-016-4818-4

    Article  PubMed  Google Scholar 

  11. Phan K, Rao PJ, Mobbs RJ (2015) Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: systematic review and meta-analysis of comparative studies. Clin Neurol Neurosurg 135:85–92. https://doi.org/10.1016/j.clineuro.2015.05.016

    Article  PubMed  Google Scholar 

  12. Caruso G, Lombardi E, Andreotti M et al (2018) Minimally invasive fixation techniques for thoracolumbar fractures: comparison between percutaneous pedicle screw with intermediate screw (PPSIS) and percutaneous pedicle screw with kyphoplasty (PPSK). Eur J Orthop Surg Traumatol 28:849–858. https://doi.org/10.1007/s00590-018-2122-1

    Article  PubMed  Google Scholar 

  13. Belkoff SM, Mathis JM, Fenton DC, et al (2001) An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture. Spine (Phila Pa 1976) 26:151–6 . https://doi.org/10.1097/00007632-200101150-00008

  14. Vanni D, Pantalone A, Bigossi F et al (2012) New perspective for third generation percutaneous vertebral augmentation procedures: preliminary results at 12 months. J craniovertebral junction spine 3:47–51. https://doi.org/10.4103/0974-8237.116537

    Article  Google Scholar 

  15. Vanni D, Galzio R, Kazakova A et al (2016) Third-generation percutaneous vertebral augmentation systems. J Spine Surg 2:13–20. https://doi.org/10.21037/jss.2016.02.01

    Article  PubMed  PubMed Central  Google Scholar 

  16. Krüger A, Oberkircher L, Figiel J et al (2015) Height restoration of osteoporotic vertebral compression fractures using different intravertebral reduction devices: a cadaveric study. Spine J 15:1092–1098. https://doi.org/10.1016/j.spinee.2013.06.094

    Article  PubMed  Google Scholar 

  17. Reinhold M, Audigé L, Schnake KJ et al (2013) AO spine injury classification system: a revision proposal for the thoracic and lumbar spine. Eur Spine J 22:2184–2201. https://doi.org/10.1007/s00586-013-2738-0

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sadiqi S, Verlaan JJ, Lehr AM et al (2017) Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study. Eur Spine J 26:1483–1491. https://doi.org/10.1007/s00586-016-4716-9

    Article  PubMed  Google Scholar 

  19. Vialle R, Levassor N, Rillardon L et al (2005) Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am 87:260–7. https://doi.org/10.2106/JBJS.D.02043

    Article  PubMed  Google Scholar 

  20. Heintel TM, Berglehner A, Meffert R (2013) Accuracy of percutaneous pedicle screws for thoracic and lumbar spine fractures: a prospective trial. Eur Spine J 22:495–502. https://doi.org/10.1007/s00586-012-2476-8

    Article  PubMed  Google Scholar 

  21. Jeong W-J, Kim J-W, Seo D-K et al (2013) Efficiency of ligamentotaxis using PLL for thoracic and lumbar burst fractures in the load-sharing classification. Orthopedics 36:e567-74. https://doi.org/10.3928/01477447-20130426-17

    Article  PubMed  Google Scholar 

  22. Noriega D, Maestretti G, Renaud C et al (2015) Clinical performance and safety of 108 SpineJack implantations: 1-year results of a prospective multicentre single-arm registry study. Biomed Res Int 2015:1–10. https://doi.org/10.1155/2015/173872

    Article  CAS  Google Scholar 

  23. Baeesa SS, Krueger A, Aragón FA, Noriega DC (2015) The efficacy of a percutaneous expandable titanium device in anatomical reduction of vertebral compression fractures of the thoracolumbar spine. Saudi Med J 36:52–60. https://doi.org/10.15537/smj.2015.1.9463

    Article  PubMed  PubMed Central  Google Scholar 

  24. Premat K, Vande Perre S, Cormier É et al (2018) Vertebral augmentation with the SpineJack® in chronic vertebral compression fractures with major kyphosis. Eur Radiol 28:4985–4991. https://doi.org/10.1007/s00330-018-5544-6

    Article  PubMed  Google Scholar 

  25. Li D, Huang Y, Yang H et al (2014) Jack vertebral dilator kyphoplasty for treatment of osteoporotic vertebral compression fractures. Eur J Orthop Surg Traumatol 24:15–21. https://doi.org/10.1007/s00590-012-1131-8

    Article  PubMed  Google Scholar 

  26. Noriega DC, Rodrίguez-Monsalve F, Ramajo R et al (2019) Long-term safety and clinical performance of kyphoplasty and SpineJack® procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study. Osteoporos Int 30:637–645. https://doi.org/10.1007/s00198-018-4773-5

    Article  CAS  PubMed  Google Scholar 

  27. Noriega D, Marcia S, Theumann N et al (2019) A prospective, international, randomized, noninferiority study comparing an implantable titanium vertebral augmentation device versus balloon kyphoplasty in the reduction of vertebral compression fractures (SAKOS study). Spine J 19:1782–1795. https://doi.org/10.1016/j.spinee.2019.07.009

    Article  PubMed  Google Scholar 

  28. Karami KJ, Buckenmeyer LE, Kiapour AM et al (2015) Biomechanical evaluation of the pedicle screw insertion depth effect on screw stability under cyclic loading and subsequent pullout. J Spinal Disord Tech 28:E133-9. https://doi.org/10.1097/BSD.0000000000000178

    Article  PubMed  Google Scholar 

  29. Li K, Zhang W, Liu D, et al (2016) Pedicle screw fixation combined with intermediate screw at the fracture level for treatment of thoracolumbar fractures: a meta-analysis. Med (United States) 95. https://doi.org/10.1097/MD.0000000000004574

  30. Ye C, Luo Z, Yu X et al (2017) Comparing the efficacy of short-segment pedicle screw instrumentation with and without intermediate screws for treating unstable thoracolumbar fractures. Med (United States) 96:1–5. https://doi.org/10.1097/MD.0000000000007893

    Article  Google Scholar 

  31. Tian J, Wang L, Xia T et al (2011) Posterior short-segmental fixation combined with intermediate screws vs conventional intersegmental fixation for monosegmental thoracolumbar fractures. Orthopedics 34:e389-96. https://doi.org/10.3928/01477447-20110627-08

    Article  PubMed  Google Scholar 

  32. Wang X-Y, Dai L-Y, Xu H-Z, Chi Y-L (2008) Kyphosis recurrence after posterior short-segment fixation in thoracolumbar burst fractures. J Neurosurg Spine 8:246–54. https://doi.org/10.3171/SPI/2008/8/3/246

    Article  PubMed  Google Scholar 

  33. Xu B, shan, Tang T si, Yang H lin, (2009) Long-term results of thoracolumbar and lumbar burst fractures after short-segment pedicle instrumentation, with special reference to implant failure and correction loss. Orthop Surg 1:85–93. https://doi.org/10.1111/j.1757-7861.2009.00022.x

    Article  PubMed  PubMed Central  Google Scholar 

  34. Lee KY, Kim MW, Seok SY et al (2017) The relationship between superior disc-endplate complex injury and correction loss in young adult patients with thoracolumbar stable burst fracture. CiOS Clin Orthop Surg 9:465–471. https://doi.org/10.4055/cios.2017.9.4.465

    Article  PubMed  Google Scholar 

  35. Formica M, Cavagnaro L, Basso M et al (2016) Which patients risk segmental kyphosis after short segment thoracolumbar fracture fixation with intermediate screws? Injury 47:S29–S34. https://doi.org/10.1016/j.injury.2016.07.048

    Article  PubMed  Google Scholar 

  36. Maestretti G, Cremer C, Otten P, Jakob RP (2007) Prospective study of standalone balloon kyphoplasty with calcium phosphate cement augmentation in traumatic fractures. Eur Spine J 16:601–610. https://doi.org/10.1007/s00586-006-0258-x

    Article  PubMed  Google Scholar 

  37. Han M-S, Lee G-J, Lee S-K et al (2021) Risks and benefits of timely screw removal after thoracolumbar spine fractures treated with non-fusion technique. J Clin Neurosci 89:397–404. https://doi.org/10.1016/j.jocn.2021.05.035

    Article  PubMed  Google Scholar 

  38. Aono H, Ishii K, Takenaka S et al (2019) Risk factors for a kyphosis recurrence after short-segment temporary posterior fixation for thoracolumbar burst fractures. J Clin Neurosci 66:138–143. https://doi.org/10.1016/j.jocn.2019.04.035

    Article  PubMed  Google Scholar 

  39. Bironneau A, Bouquet C, Millet-Barbe B et al (2011) Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: a prospective cohort study of 24 patients with one year of follow-up. Orthop Traumatol Surg Res 97:389–395. https://doi.org/10.1016/j.otsr.2011.02.009

    Article  CAS  PubMed  Google Scholar 

  40. Finoco M, Dejean C, Giber D et al (2022) Implant removal after short percutaneous pedicle fixation associated with SpineJack® kyphoplasty: is correction sustained? Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-022-04726-5

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Orthopaedic Surgery Unit, Hôpital Européen Georges Pompidou, APHP, 20 rue Leblanc, 75015, Paris, France

    Mikael Finoco, Charles Dejean, Emmanuelle Ferrero & Marc Khalifé

  2. Université de Paris, Paris, France

    Mikael Finoco, Charles Dejean, Emmanuelle Ferrero & Marc Khalifé

  3. Orthopaedic Surgery Unit, Henri Mondor University Hospital, 1 rue Gustave Eiffel, 94000, Créteil, France

    David Giber, Claire Bastard & Arnaud Dubory

  4. Université Paris XII, Créteil, France

    David Giber, Claire Bastard & Arnaud Dubory

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  1. Mikael Finoco
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  2. Charles Dejean
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  3. David Giber
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  4. Claire Bastard
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Contributions

Finoco: data collection, article writing

Dejean: data collection

Giber: data collection

Bastard: data collection

Ferrero: reviewing

Dubory: reviewing

Khalifé: direction, statistical analyses, reviewing

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Correspondence to Marc Khalifé.

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Conflict of interest

Marc Khalifé holds shares of the NovaSpine company, which presents no competing interest with the present study.

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Finoco, M., Dejean, C., Giber, D. et al. Sagittal correction after short percutaneous fixation for thoracolumbar compression fractures: comparison of the combination of SpineJack® kyphoplasty and fractured vertebra screw fixation. International Orthopaedics (SICOT) 47, 1295–1302 (2023). https://doi.org/10.1007/s00264-023-05734-9

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