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Balloon-Kyphoplasty compared to SpineJack Implants

Vertebral Fracture Treatment: Balloon-Kyphoplasty compared to SpineJack Implants

Kyphoplasty has been the gold standard treatment for Vertebral Compression Fractures (VCF) for 20 years. It’s a successful procedure that brings immediate pain relief. Nowadays, SpineJack implants offers a new way of controlled and minimally invasive solution.

Which Fractures can be treated?

Like all fractures, VCF can be caused by injury, by the poor quality of bone due to osteoporosis or from the presence of a tumor or a metastasis in the bone that makes it fragile. Moreover, VCF were classified based on how and where the vertebral body is affected. The choice of the treatment depends on many variables and is different for each patient.

Balloon kyphoplasty can be used easily to treat A1 and A2 fractures and generally becomes more challenging for A3 fractures due to the multiple fragments of the bone and the maximum pressure that the balloon can withstand. Depending on the quality of the bone and the history of the patient, it may also be a problem to create cavities in the trabecular bone.

The indications for SpineJack implants are broader as the implant overcomes several issues that are faced with the balloons. Indeed, the titanium implant can provide more force to lift the endplate and restore the anatomy of the vertebra with a unidirectional expansion. Thanks to its small profile, the SpineJack implant does not form a cavity like the balloons and allows to maintain patient’s healthy bone. SpineJacks can treat fractures from A1 to A4, whether due to a trauma, osteoporosis or related to a tumor or metastasis.

Difference of Procedure

From a technical point of view, the procedure itself is very similar. The SpineJacks are implanted in a minimally invasive procedure after a bipedicular access and a rapid implant site preparation. The procedure can be as short as 20 minutes including the preparation and injection of a high-viscosity cement that reduces the risk of leaks. The SpineJack implants are available in three different sizes to adapt to the patient’s anatomy and fracture.

Comparison of the Treatment Results

Both, balloon kyphoplasty and kyphoplasty with SpineJack give very satisfying results in terms of pain relief. [1]

Inflating the balloon creates an important cavity in the vertebral body that must be filled with cement to maintain the restoration. SpineJack has the advantage of preserving the bone which also minimizes the amount of injected cement. [2]

When using balloons, the height recovery is not always observed. Indeed, the balloon does not always have enough pressure to push all fragments back into place, and more importantly, they follow the path of less resistance as they are inflated with the contrast medium. This means that the balloon expands around the harder part of the bone and therefore may not be able to restore the original anatomy of the vertebra.

Another issue is that a re-collapse of the vertebral body is often observed when the balloon is deflated and removed from the vertebra to allow cement injection.

The SpineJack achieved a better restoration of the vertebral body, not only when measuring the height of the vertebra, but also when measuring the angles between the treated level and the adjacent levels. [3] [4] This results in an anatomical restoration, and follow-up studies have shown that the risk of adjacent segment disease with SpineJack is lower (around 3 %) compared to balloon kyphoplasty (around 15 %) [4]. [5] [6]

Kyphoplasty is a successful procedure that yields good results for patients both on short and long-term patient. There are new devices like SpineJack implants, that take this simple surgery to a new level and help you to treat your patients as well as possible.

References

  1. Vanni et al., 2012 – New perspective for third generation percutaneous vertebral augmentation procedures Preliminary results at 12 months
  2. Rotter et al., 2015 – Minimum cement volume required in vertebral body augmentation – A biomechanical study comparing the permanent SpineJack device and balloon kyphoplasty in traumatic fracture
  3. Crespo-Sanjuan et al., 2017 – Requirements for a Stable Long-Term Result in Surgical Reduction of Vertebral Fragility Fractures
  4. Baeesa Krüger – 2015 – The efficacy of a percutaneous expandable titanium device
  5. Noriega et al., 2015 – Clinical Performance and Safety of 108 SpineJack Implantations-1-Year Results of a Prospective Multicentre Single-Arm Registry Study
  6. Renaud et al., 2015 – Treatment of vertebral compression fractures with the cranio-caudal expandable implant SpineJack® – Technical note and outcomes in 77consecutive patients

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