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A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures
PURPOSE: To compare the biomechanical behavior of vertebrae with vertebral compression fractures (VCF) treated by a novel system with pedicular anchorage (dowelplasty) versus balloon kyphoplasty. METHODS: Four cadaveric spines (T12-L5) were harvested, cleaned from soft tissues, and separated into ve...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361952/ https://www.ncbi.nlm.nih.gov/pubmed/37477733 http://dx.doi.org/10.1186/s40634-023-00635-7 |
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author | Le Huec, Jean-Charles Droulout, Thomas Boue, Lisa Dejour, Edouard Ramos-Pascual, Sonia Bourret, Stephane |
author_facet | Le Huec, Jean-Charles Droulout, Thomas Boue, Lisa Dejour, Edouard Ramos-Pascual, Sonia Bourret, Stephane |
author_sort | Le Huec, Jean-Charles |
collection | PubMed |
description | PURPOSE: To compare the biomechanical behavior of vertebrae with vertebral compression fractures (VCF) treated by a novel system with pedicular anchorage (dowelplasty) versus balloon kyphoplasty. METHODS: Four cadaveric spines (T12-L5) were harvested, cleaned from soft tissues, and separated into vertebrae. Axial compressive loads were applied to each vertebra until a VCF was generated. Half of the vertebrae (n = 11) were instrumented using the “dowelplasty” system, consisting of a hollow titanium dowel anchored into the pedicle, through which a cannulated titanium nail is inserted and locked and through which cement is injected. The other half (n = 11) were instrumented using balloon kyphoplasty. Axial compressive loads were re-applied to each vertebra until fracture. Fracture load and fracture energy were calculated from load–displacement data for the pre- and post-treatment states. RESULTS: Compared to balloon kyphoplasty, dowelplasty granted greater net change in fracture load (373N; 95%CI,-331–1076N) and fracture energy (755Nmm; 95%CI,-563–2072Nmm). A sensitivity analysis was performed without L4 and L5 vertebrae from the dowelplasty group, since the length of the cannulated nails was too short for these vertebrae: compared to balloon kyphoplasty, dowelplasty granted an even greater net change in fracture load (680N; 95%CI,-96–1457N) and fracture energy (1274Nmm; 95%CI,-233–2781Nmm). CONCLUSION: Treating VCFs with dowelplasty grants increased fracture load and fracture energy compared to the pre-treatment state. Furthermore, dowelplasty grants greater improvement in fracture load and fracture energy compared to balloon kyphoplasty, which suggests that dowelplasty may be a good alternative for the treatment of VCF. LEVEL OF EVIDENCE: level IV. |
format | Online Article Text |
id | pubmed-10361952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-103619522023-07-23 A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures Le Huec, Jean-Charles Droulout, Thomas Boue, Lisa Dejour, Edouard Ramos-Pascual, Sonia Bourret, Stephane J Exp Orthop Original Paper PURPOSE: To compare the biomechanical behavior of vertebrae with vertebral compression fractures (VCF) treated by a novel system with pedicular anchorage (dowelplasty) versus balloon kyphoplasty. METHODS: Four cadaveric spines (T12-L5) were harvested, cleaned from soft tissues, and separated into vertebrae. Axial compressive loads were applied to each vertebra until a VCF was generated. Half of the vertebrae (n = 11) were instrumented using the “dowelplasty” system, consisting of a hollow titanium dowel anchored into the pedicle, through which a cannulated titanium nail is inserted and locked and through which cement is injected. The other half (n = 11) were instrumented using balloon kyphoplasty. Axial compressive loads were re-applied to each vertebra until fracture. Fracture load and fracture energy were calculated from load–displacement data for the pre- and post-treatment states. RESULTS: Compared to balloon kyphoplasty, dowelplasty granted greater net change in fracture load (373N; 95%CI,-331–1076N) and fracture energy (755Nmm; 95%CI,-563–2072Nmm). A sensitivity analysis was performed without L4 and L5 vertebrae from the dowelplasty group, since the length of the cannulated nails was too short for these vertebrae: compared to balloon kyphoplasty, dowelplasty granted an even greater net change in fracture load (680N; 95%CI,-96–1457N) and fracture energy (1274Nmm; 95%CI,-233–2781Nmm). CONCLUSION: Treating VCFs with dowelplasty grants increased fracture load and fracture energy compared to the pre-treatment state. Furthermore, dowelplasty grants greater improvement in fracture load and fracture energy compared to balloon kyphoplasty, which suggests that dowelplasty may be a good alternative for the treatment of VCF. LEVEL OF EVIDENCE: level IV. Springer Berlin Heidelberg 2023-07-21 /pmc/articles/PMC10361952/ /pubmed/37477733 http://dx.doi.org/10.1186/s40634-023-00635-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Le Huec, Jean-Charles Droulout, Thomas Boue, Lisa Dejour, Edouard Ramos-Pascual, Sonia Bourret, Stephane A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
title | A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
title_full | A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
title_fullStr | A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
title_full_unstemmed | A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
title_short | A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
title_sort | novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361952/ https://www.ncbi.nlm.nih.gov/pubmed/37477733 http://dx.doi.org/10.1186/s40634-023-00635-7 |
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