METHOD FOR PREVENTING FRACTURES OF ADJACENT VERTEBRAE DURING TRANSPEDICULAR FIXATION IN OSTEOPOROSIS

Objective. To substantiate experimentally a method for preventing adjacent vertebra fractures during cement transpedicular fixation of vertebral fractures in osteoporotic patients.

Material and Methods. An experimental study included the assessment of overall strength of 10 cadaver blocks of Th₁₀-L₄ vertebral segments with simulated Magerl’s type A fracture at the L₁ level and transpedicular fixation at the Th₁₂-L₂ levels with four-screw system and cement augmentation. In five control blocks, only cement augmented transpedicular fixation was performed after the L₁ fracture simulation. In five blocks of the study group it was supplemented by vertebroplasty at Th₁₁ and L₃ levels cranial and caudal to the level of fixation. Load testing of the blocks was carried out by destruction under the influence of a vertically directed force.

Results. Vertical loading of anatomical specimens in the control group (average of 0.84 kN) caused Th₁₁ vertebral body fractures. In the study group, the vertebrae augmented by vertebroplasty were resistant to loading. Fractures occurred in the Th10 vertebral bodies (over the vertebra with vertebroplasty) under the average load of 1.91 kN.

Conclusion. Vertebroplasty of the vertebra overlying the level of transpedicular fixation is an effective way to prevent its fracture.

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