Article Text

Case series
Treatment of A3.2 and A2 traumatic thoracolumbar spine compression fractures using vertebral body stenting: a 63-patient series
  1. Henri Salle1,
  2. Gia van Tran1,
  3. Patrick Faure1,
  4. Charbel Mounayer2,
  5. Aymeric Rouchaud2,3,
  6. Laurence Salle4,
  7. François Caire1
  1. 1Department of Neurosurgery, CHU Limoges, Limoges, Limousin, France
  2. 2Department of Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
  3. 3Univ. Limoges, CNRS, XLIM, UMR 7252, Limoges, France
  4. 4Unité Inserm UMR 1094 Neuroépidémiologie Tropicale, Limoges, France
  1. Correspondence to Dr Henri Salle, Department of Neurosurgery, CHU Limoges, 87042 Limoges, France; henrisalle1{at}gmail.com

Abstract

Background Percutaneous treatments for spinal injury are underused by neuroradiologists and spine surgeons, mainly owing to a lack of data on indications.

Objective To assess the safety and efficacy of vertebral body stenting (VBS) for post-traumatic A3.2 and A2 fractures (Magerl classification) and determine the factors that influence the improvements.

Methods We retrospectively reviewed patients who underwent VBS to treat a single traumatic thoracolumbar fracture from 2010 to 2019. Kyphosis, loss of vertebral body height (VBH), and clinical and functional outcomes (including the Visual Analog Scale pain score and Oswestry Disability Index) were assessed. We examined the overall effects of VBH in all patients by constructing a linear statistical model and evaluated whether the efficacy was dependent on the characteristics of the patients or fractures.

Results We included 63 patients comprising 44 A3.2 and 19 A2 fractures. No patient had worsening neurological symptoms or wound infection. The average rates of change were 67.1% (95% CI 59.1% to 75%) for kyphosis and 88.5% (95% CI 85.6% to 91.3%) for VBH (both p<0.0001). After 1 year, the VBS treatment was more effective for kyphosis in younger patients and at the L1 level, and for VBH in younger patients and cases of Magerl A3.2 fracture.

Conclusions This large reported series on VBS validates this surgical treatment. All patients had improved kyphosis and restored VBH. We recommend using VBS rather than open surgery for A3.2 and A2 fractures at the thoracolumbar junction and in young patients.

  • spine
  • trauma
  • stent

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Footnotes

  • Contributors HS, PF, CM, LS, and FC: study conception, design, data acquisition, interpretation, and drafting the manuscript and critically revising it. GvT, LS, AR: contributed to data acquisition and critical revisions of the manuscript. All authors approved the final manuscript and are accountable for all aspects of the works.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.