Biomechanical Comparisons between One- and Two-Compartment Devices for Reconstructing Vertebrae by Kyphoplasty

Abstract

Background: This biomechanical in vitro study compared two kyphoplasty devices for the extent of height reconstruction, load-bearing capacity, cement volume, and adjacent fracture under cyclic loading. Methods: Multisegmental (T11–L3) specimens were mounted into a testing machine and subjected to compression, creating an incomplete burst fracture of L1. Kyphoplasty was performed using a one- or two-compartment device. Then, the testing machine was used for a cyclic loading test of load-bearing capacity to compare the two groups for the amount of applied load until failure and subsequent adjacent fracture. Results: Vertebral body height reconstruction was effective for both groups but not statistically significantly different. After cyclic loading, refracture of vertebrae that had undergone kyphoplasty was not observed in any specimen, but fractures were observed in adjacent vertebrae. The differences between the numbers of cycles and of loads were not statistically significant. An increase in cement volume was strongly correlated with increased risks of adjacent fractures. Conclusion: The two-compartment device was not substantially superior to the one-compartment device. The use of higher cement volume correlated with the occurrence of adjacent fractures.

Keywords

• spinal biomechanics
• spinal fracture
• vertebral body
• kyphoplasty
• cement volume
• load bearing