Reinforcement of Thoracolumbar Burst Fractures With Calcium Phosphate Cement
- 1 March 1998
- journal article
- Published by Wolters Kluwer Health in Spine
- Vol. 23 (6), 664-670
- https://doi.org/10.1097/00007632-199803150-00004
Abstract
A biomechanical study on the stabilization of thoracolumbar burst fractures. To demonstrate that the addition of a calcium phosphate cement into the fractured vertebral body through a transpedicular approach is a feasible technique that improves the stiffness of a transpedicular screw construct. Short segment pedicle screw instrumentation is a commonly used method for reduction and stabilization of unstable burst fractures. Recent investigators, however, have reported a high rate of instrumentation failure and sagittal collapse when there is a loss of anterior column support. In this study, the ability of a new hydroxyapatite cement to augment anterior column support was investigated in a burst fracture model. A cadaveric L1 burst fracture model was stabilized using short segment pedicle screw instrumentation. Specially instrumented-pedicle screws recorded screw-bending moments. The L1 vertebral body was reinforced with the hydroxyapatite cement through a transpedicular approach. Mechanical testing of the instrumented and instrumented-reinforced constructs were performed in flexion, extension, side bending, and torsion. Construct stiffness and screw-bending moments were recorded. Transpedicular vertebral body reconstruction with hydroxyapatite cement reduced pedicle screw-bending moments by 59% in flexion and 38% in extension. Mean initial stiffness in the flexion-extension plane was increased by 40% (P < 0.05). There were no statistically significant differences in these parameters with lateral bending or torsional movements. This hydroxyapatite cement compound augments anterior column stability in a burst fracture model. This technique may improve outcomes in burst fracture patients without the need for a secondary anterior approach.Keywords
This publication has 38 references indexed in Scilit:
- The Reinforcement of Cancellous Bone Screws with Calcium Phosphate CementJournal of Orthopaedic Trauma, 1996
- Cotrel-Dubousset Hook and Screw Combination for Spine FracturesPublished by Wolters Kluwer Health ,1993
- Biomechanics of Indirect Reduction of Bone Retropulsed Into the Spinal Canal in Vertebral FractureSpine, 1993
- 1992 Volvo Award in Experimental Studies Vertebral Burst FracturesSpine, 1992
- Transpedicular Short-Segment Fusions for Treatment of Lumbar Burst FracturesJournal of Spinal Disorders, 1992
- Operative Treatment of Spinal Fractures with the AO Internal FixatorSpine, 1991
- Multidirectional Instabilities of Traumatic Cervical Spine Injuries in a Porcine ModelSpine, 1989
- Reduction of the Intracanal Fragment in Experimental Burst FracturesSpine, 1988
- The Internal Skeletal Fixation SystemPublished by Wolters Kluwer Health ,1988