PerspectivesVertebroplasty, Kyphoplasty, Lordoplasty, Expandable Devices, and Current Treatment of Painful Osteoporotic Vertebral Fractures
Section snippets
Surgical Options
Three-column restoration is the gold standard of vertebral body reconstruction in cases of unstable vertebral fractures. This tactic provides immediate stabilization of unstable vertebral fractures whether traumatic, neoplastic, or osteoporotic in etiology. It may be performed through anterior, anterolateral, or posterior surgical approaches. It may be a classical open procedure, a minimally invasive approach, or a combination of both. The 3-column anterolateral spinal canal decompression
The Case for Expandable Vertebral Devices
Variable reduction devices have been used. Technologically advanced, specific tools facilitate the innovative minimally invasive insertion within the osteoporotic fractured vertebral bodies. A vertebral body cement container may be a balloon (kyphoplasty), a porous vessel balloon (vesselplasty), titanium expansible support (SpineJack; VEXIM SA, Balma, France), or coil filled system (Kiva; Benvenue Medical, Inc., Santa Clara, California, USA). Expandable vertebral devices theoretically increase
Conclusions
Minimally invasive percutaneous procedures for cementing vertebral osteoporotic fractures are appealing to patients. Early ambulation and immediate pain control is achieved. Percutaneous expandable vertebral devices to support the endplate and decrease cement leakage are currently more efficient. Unipedicular cement delivery may be desirable. Cementing materials may be further improvised to be more compatible with physical and mechanical properties of normal bone to decrease the incidence of
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Cited by (0)
Commentary on: Better Height Restoration, Greater Kyphosis Correction, and Fewer Refractures of Cemented Vertebrae by Using an Intravertebral Reduction Device: a 1-Year Follow-up Study by Lin et al. World Neurosurg 90:391-396, 2016