First intention vertebroplasty in fractures within an ankylosed thoracolumbar spinal segment - 04/02/21

Doi : 10.1016/j.diii.2021.01.008

Alexandre J. Prestat ^a,^b,⁎ , Pedro-Augusto Gondim Teixeira ^a, Aymeric Rauch ^a, Damien Loeuille ^c, Pierre-Henri Pretat ^d, Matthias Louis ^a, Alain Blum ^a
^a Guilloz Imaging Department, Central Hospital, University Hospital of Nancy (CHRU-Nancy), 54035 Nancy cedex, France
^b Department of Musculoskeletal Radiology, Hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
^c Department of Rheumatology, Central Hospital, University Hospital Center of Nancy (CHRU-Nancy), 54511 Vandoeuvre-Lès-Nancy, France
^d Department of Neurosurgery, Central Hospital, University Hospital Center of Nancy (CHRU-Nancy), 54035 Nancy cedex, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 04 February 2021
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Highlights

•	Percutaneous vertebral cementoplasty is a safe alternative to open surgical procedures in elderly and fragile patients with vertebral fracture in ankylosed spine.
•	Percutaneous vertebral cementoplasty of ankylosed spinal segments can provide primary and secondary success rates of 61% and 87%, respectively.
•	Percutaneous vertebral cementoplasty results in a null pain score in 84% of patients with vertebral fracture in ankylosed spine at one year.

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Abstract

Purpose

To evaluate the outcome of percutaneous vertebral cementoplasty (PVC) as the first-line treatment for traumatic thoracolumbar fractures within an ankylosed spinal segment.

Materials and methods

Thirty-one patients (15 men, 16 women; mean age: 79.2±11 [SD] years; age range: 66–95 years) with thoracolumbar fractures within an ankylosed spine segment without neurological impairment treated with PVC were retrospectively evaluated. All patients were controlled at six weeks and one year after PVC. Ankylosing conditions, fractures sites and types, radiological consolidation, spinal complications were assessed. Anterior/posterior vertebral height ratios were measured before and after PVC. Postoperative pain relief and treatment success (radiological fracture consolidation) rates were considered.

Results

The 31 patients had a total of 39 fractures (19 stable [49%], 20 unstable [51%]) treated with PVC. Primary success rate of PVC (initial fracture consolidation without complication) was 61% (19/31). Seven patients (7/31; 23%) exhibited new fractures, and the secondary success rate of PVC (global fracture consolidation one year after repeat PVC) was 87% (34/39). Global consolidation rates of unstable fractures were 85% (17/20) of treated levels. Pain score was null in 84% patients (26/31) one year after PVC. There were no significant differences between pre-PVC (0.62±0.18 [SD]; range: 0.22–0.88) and post-PVC (0.60±0.18 [SD]; range: 0.35–0.88) vertebral height ratios (P=0.94).