EXPANDABLE INTRAVERTEBRAL IMPLANTS IN POST-TRAUMATIC VERTEBRAL NECROSIS - NEW CLASSIFICATION SUGGESTION

Area of Science:

• Spine Traumatology
• Orthopedic Surgery
• Biomaterials and Implants

Background:

• Post-traumatic vertebral necrosis leads to structural compromise and neurological risk, posing a significant challenge in spine traumatology.
• Current treatment options like vertebroplasty, kyphoplasty, and corpectomy lack a defined therapeutic algorithm for this complex pathology.

Purpose of the Study:

• To review the current evidence on expandable intravertebral implants for treating post-traumatic vertebral necrosis.
• To propose a simplified classification and an initial therapeutic algorithm for post-traumatic vertebral necrosis.
• To suggest preventive strategies based on identified risk factors.

Main Methods:

• Review of existing scientific literature on post-traumatic vertebral necrosis and expandable intravertebral implants.
• Analysis of mechanical characteristics of available expandable intravertebral implants.
• Development of a simplified classification based on morphology, mobility, and surgical guidance parameters.

Main Results:

• Expandable intravertebral implants demonstrate potential for intrasomatic filling and height maintenance in treating vertebral fractures and non-unions.
• A proposed classification and initial therapeutic algorithm are presented, considering disease stages and risk factors.
• Fracture comminution and impaired vertebral vascularity are identified as key risk factors for post-traumatic vertebral necrosis.

Conclusions:

• Expandable intravertebral implants represent a viable and promising option for managing post-traumatic vertebral necrosis.
• Further large-scale prospective studies are essential to validate the proposed algorithm, confirm implant efficacy, and define specific indications.
• Preventive strategies targeting fracture comminution and vascularity impairment are crucial for managing this condition.