scholarly journals Height and Volume Restoration In Osteoporotic Vertebral Compression Fractures: A Biomechanical Comparison Of Standard Balloon Kyphoplasty Versus Tektona In A Cadaveric Fracture Model

2020 ◽  
Author(s):  
Antonio Krüger ◽  
Martin Bäumlein ◽  
Tom Knauf ◽  
Hugues Pascal-Moussellard ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Balloon Kyphoplasty ◽  
Ct Scans ◽  
Matched Pair ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Before And After ◽  
Vertebral Bodies ◽  
The Difference

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.

scholarly journals Height and volume restoration in osteoporotic vertebral compression fractures: a biomechanical comparison of standard balloon kyphoplasty versus Tektona® in a cadaveric fracture model

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Antonio Krüger ◽  
Martin Bäumlein ◽  
Tom Knauf ◽  
Hugues Pascal-Moussellard ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Balloon Kyphoplasty ◽  
Ct Scans ◽  
Matched Pair ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Before And After ◽  
Vertebral Bodies ◽  
The Difference

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.

Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures

2011 ◽  
Vol 14 (5) ◽  
pp. 561-569 ◽  
Author(s):  
Majid Reza Farrokhi ◽  
Ehsanali Alibai ◽  
Zohre Maghami
Keyword(s):  
Randomized Controlled Trial ◽  
Percutaneous Vertebroplasty ◽  
Controlled Trial ◽  
Body Height ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Randomized Controlled ◽  
Before And After ◽  
Sagittal Index

Object Osteoporotic vertebral compression fractures (VCFs) are a major cause of increased morbidity in older patients. This randomized controlled trial compared the efficacy of percutaneous vertebroplasty (PV) versus optimal medical therapy (OMT) in controlling pain and improving the quality of life (QOL) in patients with VCFs. Efficacy was measured as the incidence of new vertebral fractures after PV, restoration of vertebral body height (VBH), and correction of deformity. Methods Of 105 patients with acute osteoporotic VCFs, 82 were eligible for participation: 40 patients underwent PV and 42 received OMT. Primary outcomes were control of pain and improvement in QOL before treatment, and these were measured at 1 week and at 2, 6, 12, 24, and 36 months after the beginning of the treatment. Radiological evaluation to measure VBH and sagittal index was performed before and after treatment in both groups and after 36 months of follow-up. Results The authors found a statistically significant improvement in pain in the PV group compared with the OMT group at 1 week (difference −3.1, 95% CI −3.72 to −2.28; p < 0.001). The QOL improved significantly in the PV group (difference −14, 95% CI −15 to −12.82; p < 0.028). One week after PV, the average VBH restoration was 8 mm and the correction of deformity was 8°. The incidence of new fractures in the OMT group (13.3%) was higher than in the PV group (2.2%; p < 0.01). Conclusions The PV group had statistically significant improvements in visual analog scale and QOL scores maintained over 24 months, improved VBH maintained over 36 months, and fewer adjacent-level fractures compared with the OMT group.

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