Thoraco-lumbar traumatic vertebral fractures augmentation by osteo-conductive and osteo-inductive bone substitute containing strontium-hydroxyapatite: our experience

Neuroradiology. 2014 Jun;56(6):459-66. doi: 10.1007/s00234-014-1351-1. Epub 2014 Mar 21.

Abstract

Introduction: The aim of our study was to evaluate the effectiveness of osteointegrable strontium-hydroxyapatite (Sr-HA) bone cement in the treatment of thoracolumbar traumatic vertebral fractures by percutaneous vertebroplasty (VTP).

Methods: We treated 35 patients [29 (82.85 %) men, 6 (17.14 %) women, mean age 34.05 ± 8.36 years (range 21-54 years)] with single type A1.1 and A1.2 thoracolumbar traumatic vertebral fracture without endospecal bone fragments. Pain intensity was evaluated before and at 1 day; 1 week; and 1, 6, and 12 months after VTP by a 10-point visual analog scale (VAS) score (0 = no pain, 10 = unbearable pain). Physical status and quality of life were evaluated by Oswestry Disability Index (ODI) questionnaire before and 1, 6, and 12 months after VTP.

Results: Procedural technical success was achieved in all patients with no deaths observed during follow-up. In three patients (8.57 %), postprocedural CT showed cement leakages: one intradiscal and two in venous plexus. No adjacent vertebral body fractures nor intrasomatic recollapse was detected. The VAS and ODI scores showed a statistically significant reduction 1 week after procedure (P value <0.0001) with a progressive statistically significant reduction during follow-up (P value <0.0001). Twenty-three patients (65.71 %) assigned a value of 0 to the VAS scale at 1 year after treatment.

Conclusions: Strontium-hydroxyapatite bone cement is an effective and safe bone filler in percutaneous vertebroplasty with low leakage rate and absence of major complications when performed by a skilled equipe. It allows an immediate and long-lasting stabilization with a significant pain reduction and quality of life improvement.

MeSH terms

  • Adult
  • Bone Cements / therapeutic use*
  • Bone Substitutes / therapeutic use*
  • Disability Evaluation
  • Female
  • Humans
  • Hydroxyapatites / therapeutic use*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Male
  • Middle Aged
  • Pain Measurement
  • Prospective Studies
  • Quality of Life
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Strontium / therapeutic use*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vertebroplasty / methods*

Substances

  • Bone Cements
  • Bone Substitutes
  • Hydroxyapatites
  • strontium hydroxyapatite
  • Strontium