Management of Vertebral Compression Fractures Using a Titanium Expandable Device and a Demineralised Bone Matrix Graft

Abstract

Objective: This study was conducted to evaluate the efficacy of using expendable mesh with DBM bone graft in short- and long-term treatment clinically, back to normal activities and complications.

Questions/purposes: An alternative treatment with less cement related complication to treat vertebral compression fractures. Patients and Methods: Forty patients with thoracolumbar vertebral compression fractures underwent this operation over 2 years period, at one centre under one surgeon at Soliman Fakeeh Hospital. We evaluated pain relief and improvement of daily activity function using visual analogue scale (VAS) score and Oswestry disability index (ODI) system pre-, post and one year after the operation. At the same times, we also assessed kyphotic angles (KA) and Cobb angle (CA) using plain x-rays and computed tomography (CT).

Results: We found significant improvement of daily activity functions and pain relief as we found a statistically significant decrease in VAS score when compared pre-operatively (8.80 ± 1.13) to immediately and two years post-operatively respectively (4.2 ± 1.27, 1.18 ± 1.36, p = 0.018). There was also a statistically significant decrease in ODI system scores when pre-operative scores (91.35% ± 2.24%) were compared to immediate and two years post-operative scores (40.3% ± 16.43%, 29.40% ± 16.63%, p = 0.012). Both KA and CA showed significant improvements postoperatively (KA 20.33 o ± 6.16° to 10.55° ± 4.11°, p = 0.002/ CA 10.5° ± 4.273° to 7.12° ± 2.99°, p = 0.001). There was no statistically significant difference in terms of KA and CA during the follow-up period (p > 0.05).

Conclusions/Clinical Relevance: This approach is effective in treatment of such cases providing better quality of life by immediate and sustained relief of pain and less hospital stay. It also improves both KA and CA immediately after the operation with maintenance of stable radiological progression through the period of follow-up. Also, it is also a safe procedure.