Burst-fractures and cementoplasty

Percutaneous acrylic cement vertebroplasty is known for its pain-relieving effect in spinal tumors and recently in osteoporotic vertebral collapse. To our knowledge no study has been published reporting the treatment of acute high energy post-traumatic fracture (mainly single burst fracture) by vertebroplasty. Our purpose was to evaluate the technical feasibility of the cement injection at this acute phase, assess its the impact on the pain and monitor spinal stability, by quantifying potential kyphosis modification. Twelve patients with relative contraindication of the orthopaedic treatment were treated by early injection after the trauma for an A type fracture of the Magerl classification, without neurological sign. Patients surveys revealed a significant pain reduction within the first day. Half of them reduced the kyphosis angle, and the anterior height vertebral body significantly improved after the vertebroplasty. The mean reduction in the kyphosis angle was 8degrees. No complication occurred except one extravertebral asymptomatic leak, with secondary increase of the kyphosis. Vertebroplasty performed in reduction position may allow a complete stabilization without pain and furthermore can reduce the kyphosis angle.