Spine Jack® System for Percutaneous Stabilization of Osteoporotic Vertebral Compression Fractures: Clinical and Radiological Results

Abstract

Background Data: Balloon kyphoplasty allows surgeons to directly reduce the fractured vertebral body using inflatable balloons. However, the reduction cannot be maintained following balloon deflation and removal. Therefore, mechanical kyphoplasty techniques were designed to avoid loss of the reduction before cement injection and restore the vertebral body indefinitely. Study Design: A prospective cohort clinical case study. Purpose: To assess efficacy and safety of mechanical kyphoplasty using the Spine Jack® system in treatment of osteoporotic vertebral compression fractures (VCFs) of the thoracolumbar spine. Patients and Methods: During the period from April 2016 to March 2018, seventeen patients who sustained recent osteoporotic VCFs of the thoracolumbar spine, presenting with intractable back pain following one-month trial of conservative treatment, were included. Patients with pathological fractures, those with neurological deficits, or those medically unfit were excluded. The study included 6 males and 11 females with mean age of 60.37 years. Fractures were surgically treated using the Spine Jack® system that was inserted percutaneously through the transpedicular approach. Back pain intensity and degree of functional recovery were assessed using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI), respectively, whereas segmental deformity of the fractured vertebra was evaluated using standing plain X-rays and CT scan, including measurement of the local kyphotic angle and Beck Index. Results: Patients were followed for at least 6 months (mean 7.4±1.2). At final follow-up, there was significant improvement in mean VAS score (7.3 to 2.9) and mean ODI score (61.4 to 28.7). Postoperative imaging showed significant improvements in mean Beck Index (0.68 to 0.77) and mean local kyphotic angle (21.4° to 14.3°). Cement leakage was noted in 2 patients (11.7%) with no clinical relevance. None of the patients developed neurological deterioration, adjacent fracture, or hardware-related complication during the follow-up. Conclusion: Percutaneous stabilization of osteoporotic VCFs of the thoracolumbar spine using the Spine Jack® system is effective and safe even with posterior wall involvement, with significantly better outcome in terms of pain relief, functional recovery, and vertebral body restoration. (2019ESJ182)

Keywords

• vertebral compression fractures
• spine jack®
• mechanical kyphoplasty