Treatment of thoracic or lumbar burst fractures with Balloon Assisted Endplate Reduction using Tricalcium Phosphate cement: histological and radiological evaluation

Short-segment pedicle-screw instrumentation is frequently used to stabilize thoracolumbar burst fractures. A recognized disadvantage of this procedure is recurrent kyphosis from intervertebral disc creep into the fractured central endplate. Balloon Assisted Endplate Reduction (BAER) using Tricalcium...

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Bibliographic Details
Published in:BMC musculoskeletal disorders 2017-10, Vol.18 (1), p.411-411, Article 411
Main Authors: Kitzen, Joep, Schotanus, Martijn G M, Plasschaert, Herbert S W, Hulsmans, Frans-Jan H, Tilman, Pieter B J
Format: Article
Language:English
Subjects:
BAER
Biocompatibility
Biomechanics
Body height
Bone implants
Bone matrix
Bone remodeling
Calcium phosphates
Cement
Classification
Fractures
Intervertebral discs
Kyphoplasty
Kyphosis
Load
Musculoskeletal diseases
Osseointegration
Patients
Recurrent kyphosis
Studies
Surgery
TCP
Thorax
Trauma
Tricalcium phosphate
Vertebrae
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Summary:Short-segment pedicle-screw instrumentation is frequently used to stabilize thoracolumbar burst fractures. A recognized disadvantage of this procedure is recurrent kyphosis from intervertebral disc creep into the fractured central endplate. Balloon Assisted Endplate Reduction (BAER) using Tricalcium Phosphate bone cement (TCP) enables elevation of the centrally depressed endplate. Our objective was to evaluate the bone-tissue response to TCP and to analyse whether BAER using TCP can prevent recurrent kyphosis after removal of the instrumentation. Fourteen patients with traumatic thoracolumbar burst fractures were operated with BAER using TCP in combination with short-segment instrumentation. Nine months after surgery, instrumentation was removed and transpedicular biopsies were taken for histological and histochemical analysis. Roentgenograms pre- and postoperatively and at latest follow-up after removal of the instrumentation were evaluated. Average follow-up was 2.6 years. Analysis of the biopsies showed a variable degree of bone remodelling with incorporation of TCP into newly formed bone matrix. No extensive foreign body reactions, inflammation, granulomatous responses or tissue necrosis were observed. Wedge-angle, kyphosis-angle and both the anterior-posterior and central-posterior vertebral body height ratios improved significant postoperatively (p 
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-017-1770-3