The Use of SpineJack Intravertebral Implant for the Correction of Recurrent Vertebral Fracture After Kyphoplasty

This report presents a case of short-term symptomatic failure with continued vertebral collapse after a T12 kyphoplasty for an acute fracture in a severely osteoporotic elderly patient. The original trajectory of the unilateral balloon and subsequently injected bone cement failed to fill the fracture, allowing further vertebral collapse that resulted in a rapid return of pain. Within 30 days, a titanium intravertebral body implant, SpineJack® (Stryker Corp, Kalamazoo, MI), combined with injection of polymethylmethacrylate (PMMA) bone cement, was placed in the collapsed area. This provided both sagittal and coronal partial correction of the collapse, fuller distribution of bone cement throughout the fractured vertebrae, and rapid reduction of pain. which was found to have been maintained at the long-term follow-up. The article reviews the technical issues causing failure of vertebral augmentation (VA) as well as the advantage of providing a permanent internal scaffolding to ensure stabilization of any fracture, especially where there is a high risk for progressive instability, such as the thoracic-lumbar junction.