Мethod for preventing fractures of adjacent vertebrae during transpedicular fixation in osteoporosis

Abstract

Objective. To substantiate experimentally a method for preventing adjacent vertebra fractures during cement transpedicular fixation of vertebral fractures in osteoporotic patients. Material and Methods. An experimental study included the assessment of overall strength of 10 cadaver blocks of T10–L4 vertebral segments with simulated Magerl’s type A fracture at the L1 level and transpedicular fixation at the T12–L2 levels with four-screw system and cement augmentation. In five control blocks, only cement augmented transpedicular fixation was per- formed after the L1 fracture simulation. In five blocks of the study group it was supplemented by vertebroplasty at T11 and L3 levels cranial and caudal to the level of fixation. Load testing of the blocks was carried out by destruction under the influence of a vertically directed force. Results. Vertical loading of anatomical specimens in the control group (average of 0.84 kN) caused Th11 vertebral body fractures. In the study group, the vertebrae augmented by vertebroplasty were resistant to loading. Fractures occurred in the T10 vertebral bodies (over the vertebra with vertebroplasty) under the average load of 1.91 kN. Conclusion. Vertebroplasty of the vertebra overlying the level of transpedicular fixation is an effective way to prevent its fracture.

Keywords

• spine
• fracture
• experiment
• osteoporosis