The role of kyphoplasty and expandable intravertebral implants in the acute treatment of traumatic thoracolumbar vertebral compression fractures: a systematic review.

Abstract

The aim of the study was to assess the role of kyphoplasty and expandable intravertebral implants in the treatment of traumatic vertebral compression fractures. This is a systematic review. A bibliographic search was carried out in the PubMed/MEDLINE database according to PRISMA guidelines regarding kyphoplasty and expandable intravertebral implants in the treatment of traumatic thoracolumbar vertebral fractures. A total of 611 records were screened. In total, 51 studies were obtained referring to traumatic vertebral fractures treated with kyphoplasty; however, of these, only studies addressing traumatic burst fractures were selected, resulting in 12 studies: 10 about kyphoplasty and 2 regarding armed kyphoplasty. In all studies, there was a statistically significant improvement in clinical and functional parameters, restoration of vertebral height and decreasing of vertebral and segmental kyphosis. Overall, there was only a residual loss of height and a slight increase in kyphosis throughout the follow-up period, while complications consisted essentially of cement leakage, all with no clinical repercussions. After the discussion, where we address the concepts of direct and indirect reduction, the association of kyphoplasty with pedicle fixation, the potential advantages of expandable intravertebral implants, as well as the vertebral body type of filling in kyphoplasty, it is concluded that kyphoplasty demonstrates favorable outcomes as a method of posterior percutaneous transpedicular access for reconstruction of the anterior column in burst fractures. It allows for the reconstruction of the vertebral body closer to its original anatomy, carried out in a minimally invasive and safe way, which provides a clinical-functional and imaging improvement maintained at the medium-long term.