Cement augmentation techniques in traumatic thoracolumbar spine fractures

Area of Science:

• Spine surgery
• Orthopedic trauma
• Biomaterials

Background:

• Persistent central endplate depression after posterior surgery for thoracolumbar fractures can lead to anterior column insufficiency.
• Intravertebral cement augmentation is a potential solution to restore weight-bearing capacity by reducing the central endplate.

Purpose of the Study:

• To develop and evaluate less invasive surgical techniques for anterior column reconstruction in thoracolumbar fractures.
• To assess the safety, biomechanical properties, and clinical outcomes of percutaneous cement augmentation methods.

Main Methods:

• Review of human cadaveric and in vivo animal studies, and clinical trials.
• Investigation of balloon-assisted endplate reduction (BAER) and vertebroplasty in cadaveric burst fracture models.
• Histologic evaluation of cement polymers in animal models and clinical review of BAER with posterior fixation.

Main Results:

• BAER and vertebroplasty techniques are safe and effective for anterior column reconstruction.
• Calcium phosphate cements demonstrate superior in vivo histologic properties compared to methylmethacrylate.
• Anterior vertebral height restoration is achievable with BAER and posterior pedicle screw fixation, with minimal loss after cement curing.

Conclusions:

• Less invasive anterior vertebral reconstruction is feasible using percutaneous cement augmentation techniques.
• These methods offer a viable solution for managing traumatic thoracolumbar fractures with anterior column involvement.