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Vertebral augmentation with the SpineJack® in chronic vertebral compression fractures with major kyphosis

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Osteoporotic vertebral compression fractures (OVCFs) are an important health issue for which minimally invasive techniques are a feasible treatment. The SpineJack® (Vexim) is an intravertebral expandable system designed to improve the correction of the structural modifications caused by OVCFs. Its ability to stabilise and reduce OVCFs at the acute phase being already well established, we sought to evaluate the feasibility of vertebral augmentation with the SpineJack® in chronic kyphotic OVCFs.

Methods

All consecutive patients treated with the SpineJack® were prospectively included if they met the following criteria: (1) OVCF considered unstable (grade A3 according to Magerl’s classification). (2) Local kyphotic angle ≥ 20°. (3) OVCF older than 6 weeks. (4) Back pain with visual analogue scale (VAS) ≥ 4.

Results

Nineteen consecutive patients (16 women [84.2%] and 3 men [15.8%]; mean age 73.2 ± 8.2 years) were included. Treatment was performed after a mean delay of 5.8 months ± 2.9 (range 1.5–12). Median visual analogue scale significantly improved from 7 preoperatively (IQR 6–9) to 2 (IQR 1–5) at 6 months (p < 0.01). Significant kyphosis reduction (i.e. ≥ 30%) was obtained in 94.7% of cases. Secondary adjacent level fractures (SALFs) were noted in 21.1% of cases and were correlated with the importance of the kyphosis reduction.

Conclusions

Vertebral augmentation with the SpineJack® is feasible and seems able to correct major structural deformities in chronic OVCFs. SALFs were noted in a substantial amount of cases. Preventive adjacent vertebroplasty might be useful in patients with several risk factors for SALFs.

Key Points

• Vertebral augmentation with SpineJack® is effective to correct major structural deformities e.g. height loss and kyphosis.

• Successful reduction is reachable with SpineJack® in chronic (older than 6 weeks) OVCFs.

• Aggressive reduction of major kyphosis might promote SALFs and complementary adjacent vertebroplasties prevent their occurrence.

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Abbreviations

BKP:

Balloon kyphoplasty

CT:

Computed tomography

IQR:

Interquartile range

MRI:

Magnetic resonance imaging

OVCF:

Osteoporotic vertebral compression fracture

PMMA:

Polymethyl methacrylate

PVP:

Percutaneous vertebroplasty

RCT:

Randomised controlled trial

SALF:

Secondary adjacent level fracture

VAS:

Visual analogue scale

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, 75013, Paris, France

    Kévin Premat, Saskia Vande Perre, Évelyne Cormier, Eimad Shotar, Frédéric Clarençon & Jacques Chiras

  2. Sorbonne University. Paris VI, Paris, France

    Eimad Shotar, Vincent Degos, Frédéric Clarençon & Jacques Chiras

  3. Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Paris, France

    Vincent Degos

  4. Department of Oncology, Pitié-Salpêtrière Hospital, Paris, France

    Laetitia Morardet

  5. Department of Pharmacy, Pitié-Salpêtrière Hospital, Paris, France

    Catherine Fargeot

Authors
  1. Kévin Premat
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  2. Saskia Vande Perre
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  3. Évelyne Cormier
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  4. Eimad Shotar
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  5. Vincent Degos
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  6. Laetitia Morardet
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  7. Catherine Fargeot
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  8. Frédéric Clarençon
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  9. Jacques Chiras
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Corresponding author

Correspondence to Frédéric Clarençon.

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Guarantor

The scientific guarantor of this publication is Frédéric Clarençon.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• experimental

• performed at one institution

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

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  • DOI: https://doi.org/10.1007/s00330-018-5544-6

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