Height and volume restoration in osteoporotic vertebral compression fractures: a biomechanical comparison of standard balloon kyphoplasty versus Tektona® in a cadaveric fracture model
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Medientyp:
E-Artikel
Titel:
Height and volume restoration in osteoporotic vertebral compression fractures: a biomechanical comparison of standard balloon kyphoplasty versus Tektona® in a cadaveric fracture model
Beschreibung:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>Standard balloon kyphoplasty represents a well-established treatment option for osteoporotic vertebral compression fractures. Aim of the present study was to evaluate two different methods of percutaneous augmentation (standard balloon kyphoplasty (BKP) versus Tektona® (TEK)) with respect to height restoration.</jats:p>
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<jats:title>Methods</jats:title>
<jats:p>Four-teen vertebral bodies of two female cadavers were examined. Fractures were created using a standardized protocol. CT-scans were taken before and after fracture, as well as after treatment. Afterwards two groups were randomly assigned in a matched pair design: 7 vertebral bodies (VB) were treated with BKP (Kyphon, Medtronic) and 7 vertebral bodies by TEK (Spineart, Switzerland) Anterior, central and posterior vertebral body heights were evaluated by CT-scans. Volumetry was performed using the CT-scans at three different timepoints.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>Values before fracture represent 100%. The anterior height after fracture was reduced to 75.99 (± 4.8) % for the BKP group and to 76.54 (± 9.17) % in the TEK Group. Statistically there was no difference for the groups (<jats:italic>p</jats:italic> = 1). After treatment the values increased to 93.06 (± 5) % for the BKP Group and 87.71 (± 6.2) % for the TEK Group. The difference before and after treatment was significant for both groups (BKP <jats:italic>p</jats:italic> = 0.0006; TEK <jats:italic>p</jats:italic> = 0.03). Within the groups, there was no difference (<jats:italic>p </jats:italic>= 0.13).</jats:p>
<jats:p>The Volume of the vertebral body was reduced to 82.29 (± 8.4) % in the BKP Group and to 76.54 (± 8.6) % in the TEK Group. After treatment the volume was 89.26 (± 6.9) % for the BKP Group and 88.80 (± 8.7) % for the TEK Group. The difference before and after treatment was significant only for the TEK group (BKP <jats:italic>p </jats:italic>= 0.0728 n.s.; TEK <jats:italic>p</jats:italic> = 0.0175). Within the groups, there was no difference (<jats:italic>p</jats:italic> = 0.2).</jats:p>
<jats:p>The average cement volume used was 6.1 (range 3.6–9 ml) for the BKP group and 5.3 (3–7.2 ml) for the TEK group respectively.</jats:p>
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<jats:title>Conclusions</jats:title>
<jats:p>Based on our results the new System Tektona® in osteoporotic compression fractures might represent a promising alternative for the clinical setting, especially preserving bone. Further biomechanical tests and clinical studies have to proof Tektona®`s capabilities.</jats:p>
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