Cone-beam computed tomography guided unipedicular central stentoplasty of the thoracolumbar spine: Early technical experience and results.

INTRODUCTION

An unipedicular vertebral body stenting technique, termed 'central stentoplasty', was developed at our institution. With this technique, a single vertebral body stent was deployed percutaneously in the midline of the vertebral body using cone-beam computed tomography (CBCT) guidance.

METHODS

From September 2013 to July 2015, forty-four patients with fifty-six vertebral bodies underwent central stentoplasty. All fractures were of osteoporotic, traumatic or malignant aetiology. Information on vertebral body deformity, pre- and post-procedure sagittal index (SI), wedge angle (WA) and anterior vertebral height ratio was analysed. Two patients had combined ablation and stentoplasty for painful spinal metastases.

RESULTS

There were 11 male and 33 female patients with mean age of 71.5 years (51-90 years). 19 fractured vertebral bodies had more than 30% loss of height. The mean pre-procedure SI was 0.82, and the mean post-procedure SI was 0.90. The pre-procedure WA was -5.56° compared with post-procedure mean WA of -3.47°. The mean pre-procedure segmental kyphosis was -4.58°, and the mean post-procedure segmental kyphosis was -1.46°. Six cases had minimal cement leak, and two cases had a haematoma at the puncture site. None of the patients underwent revision surgery, and postoperative neurological sequelae were not observed.

CONCLUSION

'Central stentoplasty' is a promising percutaneous vertebral fracture augmentation technique, which is shown to have low complication rates in the treatment of spinal compression fractures or metastases. However, long-term results need to be further evaluated.