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Song KS, Yoon BI, Ham DW. Transpedicular Intravertebral Cage Augmentation Using Expandable Cage in Kummell Disease: Technical Note and Case Series. World Neurosurg 2024; 184:119-124. [PMID: 38266993 DOI: 10.1016/j.wneu.2024.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To demonstrate the surgical techniques for transpedicular intravertebral cage augmentation (TPICA) using an expandable cage for Kummell disease, which requires posterior surgical stabilization, and provide the preliminary surgical outcomes. METHODS Six consecutive patients undergoing TPICA surgery using an expandable cage with a minimum 6-month follow-up were evaluated. Radiographic analysis to evaluate the local kyphosis angle, restoration ratio of anterior vertebral height of the index vertebra, and clinical outcomes including the Oswestry Disability Index, EuroQol 5-dimension instrument, and visual analog scale for back and leg pain, were compared between the preoperative and final follow-ups. RESULTS All patients showed improvements in all clinical outcomes and were able to walk independently without support at the last follow-up. In radiographic evaluation, the mean preoperative restoration ratio of anterior vertebral height was 41.2 ± 15.6%, which increased postoperatively to 70.3 ± 20.5% (1.70 times) and 62.4 ± 20.0% at the last follow-up (1.51 times). The mean preoperative local kyphosis angle was 10.5 ± 14.8 and was corrected to 6.0 ± 10.0 at the last follow-up. A slight loss of correction was observed between the postoperative period and the last follow-up; however, there was no clinical significance. CONCLUSIONS Expandable cages in TPICA may allow easier surgical manipulation for cage insertion around the pedicle entrance, minimizing damage to the fractured vertebral body's end plates while achieving satisfactory height restoration compared to static cages, and may also provide wider indications for TPICA surgery.
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Affiliation(s)
- Kwang-Sup Song
- Department of Orthopedic Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
| | - Byung-Il Yoon
- Department of Orthopedic Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Dae-Woong Ham
- Department of Orthopedic Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Williams TD, Adler T, Smokoff L, Kaur A, Rodriguez B, Prakash KJ, Redzematovic E, Baker TS, Rapoport BI, Yoon ES, Beall DP, Dordick JS, De Leacy RA. Bone Cements Used in Vertebral Augmentation: A State-of-the-art Narrative Review. J Pain Res 2024; 17:1029-1040. [PMID: 38505504 PMCID: PMC10949389 DOI: 10.2147/jpr.s437827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/26/2024] [Indexed: 03/21/2024] Open
Abstract
Vertebral compression fractures (VCFs) are common in osteoporotic patients, with a frequency projected to increase alongside a growing geriatric population. VCFs often result in debilitating back pain and decreased mobility. Cement augmentation, a minimally invasive surgical technique, is widely used to stabilize fractures and restore vertebral height. Acrylic-based cements and calcium phosphate cements are currently the two primary fill materials utilized for these procedures. Despite their effectiveness, acrylic bone cements and calcium phosphate cements have been associated with various intraoperative and postoperative incidents impacting VCF treatment. Over the past decade, discoveries in the field of biomedical engineering and material science have shown advancements toward addressing these limitations. This narrative review aims to assess the potential pitfalls and barriers of the various types of bone cements.
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Affiliation(s)
- Tyree D Williams
- Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Department of Neurosurgery, Mount Sinai Medical System, New York, NY, USA
| | - Talia Adler
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Columbia University School of General Studies, New York, NY, USA
| | - Lindsey Smokoff
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Columbia University School of General Studies, New York, NY, USA
| | - Anmoldeep Kaur
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Department of Neuroscience, Smith College, Northampton, MA, USA
| | - Benjamin Rodriguez
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Department of Neurosurgery, Mount Sinai Medical System, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Turner S Baker
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Department of Neurosurgery, Mount Sinai Medical System, New York, NY, USA
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin I Rapoport
- Sinai BioDesign, Mount Sinai Medical System, New York, NY, USA
- Department of Neurosurgery, Mount Sinai Medical System, New York, NY, USA
| | | | | | | | - Reade A De Leacy
- Department of Neurosurgery, Mount Sinai Medical System, New York, NY, USA
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