Abstract
This short review focuses on clinical and therapeutic issues posed by severe osteoporotic and neoplastic insufficiency vertebral fractures and on the potential use of a new technique to obtain minimally invasive vertebral body reconstruction, augmentation, and stabilization in such severe fractures, combining two preexisting procedures. The implant of vertebral body stents is followed by insertion of percutaneous, fenestrated, cement-augmented pedicular screws that act as anchors to the posterior elements for the cement–stent complex. This procedure results in a 360° nonfusion form of vertebral internal fixation that may empower vertebral augmentation and potentially avoid corpectomy in challenging osteoporotic and neoplastic fractures.
Highlights
Vertebral augmentation performed with vertebroplasty or balloon kyphoplasty might represent an under-treatment in severe osteoporotic fractures with middle column involvement
To address the limitations of standard vertebral augmentation in the most severe osteoporotic fractures and neoplastic lytic lesions, we have recently proposed the use of a new technique, called “stent-screw-assisted internal fixation (SAIF).”[14]
The SAIF is performed by combining the use of vertebral body stent (VBS) (De Puy Synthes—Johnson&Johnson®) augmentation and insertion of percutaneous cannulated fenestrated transpedicular screw (Injection pin—2B1, Milan-Italy)
Summary
Cement vertebral augmentation has been extensively used for pain palliation and stabilization of vertebral body (VB) fractures due to trauma, osteoporosis, and tumors.[1,2,3]
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