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Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population.

Abstract

INTRODUCTION

To evaluate the effectiveness of percutaneous image-guided vertebral body stenting (VBS) at restoring vertebral height in acute, stable, traumatic thoracolumbar fractures in a young, non-osteoporotic population.

MATERIALS AND METHODS

A single-centre retrospective review of all traumatic non-osteoporotic fractures treated with VBS between 2010 and 2017 was performed. Inclusion criteria included patients with recent (< 10 days), symptomatic and stable thoracolumbar compression fractures. Patients with low-energy fractures, osteoporosis and age > 60/50 years (male/female) were excluded. Primary outcomes included: correction of vertebral height, correction of kyphosis angle and Beck Index on reconstructed pre- and post-procedural CBCT images. Secondary outcomes included intra-procedural stent recoil, complications, cement leakage and factors predicting height restoration.

RESULTS

Thirty-nine patients (26 men, 13 women; mean age 33.6 years, range 15-57 years) underwent VBS 5 days post-trauma on average (range 1-10), for stable compression fractures located between T5 and L5. Mean vertebral height gain, vertebral kyphosis angle correction and Beck index improvement were 3.8 mm (95% CI 3.36-4.50; P(> 3 mm) = 99.9%), 4.3° (95% CI 3.50-5.20; P(> 3°) = 99.9%) and 0.07 [95% CI 0.053-0.11], respectively (all statistically significant). Technical success was 92%, with 3 "major" stent recoils resulting in loss of vertebral height correction. No symptomatic complications were observed. No predictive factors for procedural success were identified.

CONCLUSION

VBS can significantly restore vertebral height in young patients with traumatic vertebral compression fractures.

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  • Authors+Show Affiliations

    ,

    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France. juliengarnon@gmail.com.

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    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France. Department of Medical Imaging, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Groupe des hôpitaux universitaires Paris Ile de France Ouest, 92380, Garches, France.

    ,

    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.

    ,

    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.

    ,

    Department of Radiology, Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK.

    ,

    Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.

    ,

    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.

    ,

    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.

    Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31201507

    Citation

    Garnon, Julien, et al. "Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population." Cardiovascular and Interventional Radiology, 2019.
    Garnon J, Doré B, Auloge P, et al. Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population. Cardiovasc Intervent Radiol. 2019.
    Garnon, J., Doré, B., Auloge, P., Caudrelier, J., Dalili, D., Ramamurthy, N., ... Gangi, A. (2019). Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population. Cardiovascular and Interventional Radiology, doi:10.1007/s00270-019-02265-y.
    Garnon J, et al. Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population. Cardiovasc Intervent Radiol. 2019 Jun 14; PubMed PMID: 31201507.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population. AU - Garnon,Julien, AU - Doré,Benjamin, AU - Auloge,Pierre, AU - Caudrelier,Jean, AU - Dalili,Danoob, AU - Ramamurthy,Nitin, AU - Koch,Guillaume, AU - Cazzato,Roberto Luigi, AU - Gangi,Afshin, Y1 - 2019/06/14/ PY - 2019/02/09/received PY - 2019/06/07/accepted PY - 2019/6/16/entrez KW - Compression fractures KW - Stentoplasty KW - Vertebral body stenting KW - Vertebroplasty JF - Cardiovascular and interventional radiology JO - Cardiovasc Intervent Radiol N2 - INTRODUCTION: To evaluate the effectiveness of percutaneous image-guided vertebral body stenting (VBS) at restoring vertebral height in acute, stable, traumatic thoracolumbar fractures in a young, non-osteoporotic population. MATERIALS AND METHODS: A single-centre retrospective review of all traumatic non-osteoporotic fractures treated with VBS between 2010 and 2017 was performed. Inclusion criteria included patients with recent (< 10 days), symptomatic and stable thoracolumbar compression fractures. Patients with low-energy fractures, osteoporosis and age > 60/50 years (male/female) were excluded. Primary outcomes included: correction of vertebral height, correction of kyphosis angle and Beck Index on reconstructed pre- and post-procedural CBCT images. Secondary outcomes included intra-procedural stent recoil, complications, cement leakage and factors predicting height restoration. RESULTS: Thirty-nine patients (26 men, 13 women; mean age 33.6 years, range 15-57 years) underwent VBS 5 days post-trauma on average (range 1-10), for stable compression fractures located between T5 and L5. Mean vertebral height gain, vertebral kyphosis angle correction and Beck index improvement were 3.8 mm (95% CI 3.36-4.50; P(> 3 mm) = 99.9%), 4.3° (95% CI 3.50-5.20; P(> 3°) = 99.9%) and 0.07 [95% CI 0.053-0.11], respectively (all statistically significant). Technical success was 92%, with 3 "major" stent recoils resulting in loss of vertebral height correction. No symptomatic complications were observed. No predictive factors for procedural success were identified. CONCLUSION: VBS can significantly restore vertebral height in young patients with traumatic vertebral compression fractures. SN - 1432-086X UR - https://www.unboundmedicine.com/medline/citation/31201507/Efficacy_of_the_Vertebral_Body_Stenting_System_for_the_Restoration_of_Vertebral_Height_in_Acute_Traumatic_Compression_Fractures_in_a_Non-osteoporotic_Population L2 - https://dx.doi.org/10.1007/s00270-019-02265-y DB - PRIME DP - Unbound Medicine ER -