Balloon Kyphoplasty Versus KIVA Vertebral Augmentation—Comparison of 2 Techniques for Osteoporotic Vertebral Body Fractures

Low back pain is consistently documented as the most expensive and leading cause of disability. The majority of cases have non-specific etiologies. However, a subset of vertebral diseases has well-documented pain generators, including vertebral body tumors, vertebral body fractures, and vertebral endplate injury. Over the past two decades, specific interventional procedures targeting these anatomical pain generators have been widely studied, including spinal tumor ablation, vertebral augmentation, and basivertebral nerve ablation. This scoping review summarizes safety and clinical efficacy and discusses the impact on healthcare utilization of these interventions. Vertebral-related diseases remain a top concern with regard to prevalence and amount of health care spending worldwide. Our study shows that for a subset of disorders related to the vertebrae, spinal tumor ablation, vertebral augmentation, and basivertebral nerve ablation are safe and clinically effective interventions to decrease pain, improve function and quality of life, and potentially reduce mortality, improve survival, and overall offer cost-saving opportunities.

Download Full-text

Vertebral Augmentation Procedures for Treatment of Pathologic Vertebral Body Fractures

Central Nervous System Metastases ◽

10.1007/978-3-030-42958-4_46 ◽

2020 ◽

pp. 613-621

Author(s):

Justin Schwarz ◽

Alejandro Santillan ◽

Adham Mushtak ◽

Athos Patsalides

Keyword(s):

Vertebral Body ◽

Vertebral Augmentation ◽

Vertebral Body Fractures

Download Full-text

Stent-screw-assisted internal fixation: the SAIF technique to augment severe osteoporotic and neoplastic vertebral body fractures

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2018-014481 ◽

2018 ◽

Vol 11 (6) ◽

pp. 603-609 ◽

Cited By ~ 9

Author(s):

Alessandro Cianfoni ◽

Daniela Distefano ◽

Maurizio Isalberti ◽

Michael Reinert ◽

Pietro Scarone ◽

...

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Vertebral Body ◽

Osteoporotic Fractures ◽

Balloon Kyphoplasty ◽

Surgical Interventions ◽

Vertebral Body Fractures ◽

Cortical Shell ◽

A New Technique ◽

Middle Column

ObjectivesTo describe a new technique to obtain minimally invasive but efficient vertebral body (VB) reconstruction, augmentation, and stabilization in severe osteoporotic and neoplastic fractures, combining two pre-existing procedures. The implant of vertebral body stents (VBS) is followed by insertion of percutaneous, fenestrated, cement-augmented pedicular screws that act as anchors to the posterior elements for the cement/stent complex. The screws reduce the risk of stent mobilization in a non-intact VB cortical shell and bridge middle column and pedicular fractures. This procedure results in a 360° non-fusion form of vertebral internal fixation that may empower vertebral augmentation and potentially avoid corpectomy in challenging fractures.Procedure detailsThis report provides step-by-step procedural details, rationale, and proposed indications for this procedure. The procedure is entirely percutaneous under fluoroscopic guidance. Through transpedicular trocars the VBS are inserted, balloon-expanded and implanted in the VB. Over k-wire exchange the transpedicular screws are inserted inside the lumen of the stents and cement is injected through the screws to augment the stents and fuse the screws to the stents.ApplicationsThis technique may find appropriate applications for the most severe osteoporotic fractures with large clefts, high-degree fragmentation and collapse, middle column and pedicular involvement, and in extensive neoplastic lytic lesions.ConclusionsStent-Screw-Assisted Internal Fixation (SAIF) might represent a minimally invasive option to obtain VB reconstruction and restoration of axial load capability in severe osteoporotic and neoplastic fractures, potentially obviating the need for more invasive surgical interventions in situations that would pose significant challenges to standard vertebroplasty or balloon kyphoplasty.

Download Full-text