Efficiency of a Novel Vertebral Body Augmentation System (Tektona™) in Non-osteoporotic Spinal Fractures

BackgroundThe restauration of the local kyphosis is crucial for spinal fractures outcomes. Recently, the Tektona™, (Spine Art) system, constituted by a flexible lamella for reduction has emerged as a promising solution for osteoporotic fractures. However, no study has yet focused on its results on traumatic fractures. MethodsA retrospective longitudinal study on prospectively collected data was conducted on 53 patients. The data collected were clinical, surgical and scannographic (measurement of AVH, MVH and PVH (anterior/medium/posterior vertebral height), and RTA (regional traumatic angle) in°), preoperatively, early post-operative and at follow-up. ResultsFractures were mainly located at the upper lumbar spine and were Magerl A3.1 type for 51%. The mean RTA was 12° in pre-operative, 4° in post-operative (p=2e-9), and 8° at the last follow-up (p=0,01). The mean correction of RTA for the fixation group was -10±6° versus -7±4° for the vertebroplasty alone group (p=0,006). The mean correction for fractures located at T10-T12 was -9±3°, -9±5° for L1, -8±3° for L2 and -5±3° for L3-L5 (p=0,045). ConclusionsThe Tektona® system appears to be efficient for acute thoraco-lumbar fractures, comparable to other available systems, allowing a real intracorporeal reduction work. Its relevance, especially in the long term needs further investigation. The association of a percutaneous fixation allow to obtain a better correction of the RTA but did not seem to prevent the loss of correction at follow-up.

Research of the Clinical Effect of Kyphoplasty in the Treatment of Multiple Senile Osteoporotic Spinal Fractures

Objective: To evaluate the clinical effect of kyphoplasty in the treatment of multiple osteoporotic vertebral fractures in the elderly. Methods: The duration of the study was selected from January 2018 to December 2020, and 38 patients with multiple osteoporotic spinal fractures were selected for study evaluation. All patients were treated with kyphoplasty. The clinical indicators of the two groups were compared and analyzed. Results: The total effective rate was 94.7% and the complication rate was 5.3%. The height of midline, anterior and posterior vertebral body, Cobb angle, VAS score, ODI score and ADL score of 38 patients before and after treatment were compared, which were significantly better than those before treatment (P<0.05). Conclusion: The clinical effect of kyphoplasty in the treatment of elderly patients with multiple osteoporosis is significant, which can be promoted in all levels of medical institutions.

Trends in vertebral augmentation for spinal fractures in myeloma patients: a 2002–2012 population-based study using a large national cancer registry

PurposeTo evaluate temporal trends and factors associated with vertebral augmentation use in myeloma patients with spinal fractures from 2002 to 2012.MethodsThis retrospective cohort study used the Surveillance, Epidemiology and End Results (SEER)-Medicare claims database for 2002 through 2012. We included patients age ≥66 years with myeloma and spinal fractures. First, we evaluated receipt of vertebral augmentation. Second, multivariate logistic regression was used to assess the impact of sociodemographic factors, treatment facility type, and underlying comorbidities on the odds of undergoing vertebral augmentation.ResultsOf 4725 myeloma patients with spinal fractures, 653 underwent vertebral augmentation. Procedures increased initially from <1.7% in 2002 to 21.0% (109/520) in 2007, 18.6% (81/435) in 2008, 21.4% (109/509) in 2009, and 17.5% (76/435) in 2011. Patients with a spinal fracture before myeloma diagnosis were twice as likely to undergo vertebral augmentation as patients with fracture after myeloma diagnosis (OR 2.06, 95% CI 1.55 to 2.75). Black patients were half as likely to undergo vertebral augmentation as white patients (OR 0.48, 95% CI 0.34 to 0.68). Patients with 3–5 comorbidities (OR 0.78, 95% CI 0.64 to 0.96) and ≥6 comorbidities (OR 0.69, 95% CI 0.54 to 0.87) were less likely than patients with 0–2 comorbidities to undergo vertebral augmentation.ConclusionsVertebral augmentation for myeloma patients with spinal fractures peaked between 2007 and 2009 and then declined. Providers may have adopted vertebral augmentation in myeloma patients since its introduction, and potentially modified practice patterns following the publication of trials of vertebral augmentation in patients with osteoporotic spinal fractures.