Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study

Brian E Dalton,1 Andrew C Kohm,2 Larry E Miller,3,4 Jon E Block,4 Robert D Poser21Tri-State Neurological Surgeons, Erie, PA, 2DFINE, Inc, San Jose, CA, 3Miller Scientific Consulting, Inc, Arden, NC, 4The Jon Block Group, San Francisco, CA, USAPurpose: Traditional balloon kyphoplasty (BK) is a common...

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Autores principales:	Dalton BE, Kohm AC, Miller LE, Block JE, Poser RD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	balloon kyphoplasty fracture polymethylmethacrylate radiofrequency targeted vertebral augmentation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d9125242fb294fa2b4214dbe0f214b30
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spelling	oai:doaj.org-article:d9125242fb294fa2b4214dbe0f214b302021-12-02T06:58:48ZRadiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study1178-1998https://doaj.org/article/d9125242fb294fa2b4214dbe0f214b302012-11-01T00:00:00Zhttps://www.dovepress.com/radiofrequency-targeted-vertebral-augmentation-versus-traditional-ball-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Brian E Dalton,1 Andrew C Kohm,2 Larry E Miller,3,4 Jon E Block,4 Robert D Poser21Tri-State Neurological Surgeons, Erie, PA, 2DFINE, Inc, San Jose, CA, 3Miller Scientific Consulting, Inc, Arden, NC, 4The Jon Block Group, San Francisco, CA, USAPurpose: Traditional balloon kyphoplasty (BK) is a common treatment for symptomatic vertebral compression fractures. The purpose of this study was to compare a novel vertebral augmentation technique, radiofrequency-targeted vertebral augmentation (RF-TVA), to BK for restoration of vertebral height, cavity creation, and polymethylmethacrylate (PMMA) delivery and interdigitation into the surrounding trabeculae.Methods: This ex vivo biomechanical pilot study utilized 16 osteoporotic cadaveric vertebral bodies in a standardized fracture model to compare unipedicular RF-TVA (n = 8) to bipedicular BK (n = 8). Four specimens from each group were tested in loaded and unloaded conditions. All specimens were imaged, assessed for height restoration, and sectioned to observe PMMA distribution. A subset of specimens underwent computed tomography scanning to assess cavity creation and trabecular architecture prior to cement delivery.Results: Anterior height restoration was greater with RF-TVA (median: 84%, interquartile range: 62%–95%) compared to BK (median: 69%, interquartile range: 60%–81%), although the difference did not achieve statistical significance (P = 0.16). Anterior height restoration was numerically greater under loaded (median: 70% versus 66%) and unloaded (median: 94% versus 77%) conditions with RF-TVA versus BK. RF-TVA produced more discrete cavities and less native trabecular destruction compared to marked trabecular destruction observed with BK. RF-TVA consistently showed a well-identified focal area of PMMA with an extensive peripheral zone of PMMA interdigitation, providing mechanical interlock into the adjacent intact trabecular matrix. In contrast, BK yielded little evidence of PMMA interdigitation beyond the boundaries created by the balloon tamp due to the crushed trabecular bone peripherally.Conclusion: RF-TVA achieves favorable vertebral height restoration with targeted PMMA delivery and less trabecular destruction compared to BK. RF-TVA has potential clinical utility in the aging population with painful osteoporotic vertebral fracture.Keywords: balloon kyphoplasty, fracture, polymethylmethacrylate, radiofrequency targeted, vertebral augmentationErratum for this paper has been publishedDalton BEKohm ACMiller LEBlock JEPoser RDDove Medical Pressarticleballoon kyphoplastyfracturepolymethylmethacrylateradiofrequency targetedvertebral augmentationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 7, Pp 525-531 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	balloon kyphoplasty fracture polymethylmethacrylate radiofrequency targeted vertebral augmentation Geriatrics RC952-954.6
spellingShingle	balloon kyphoplasty fracture polymethylmethacrylate radiofrequency targeted vertebral augmentation Geriatrics RC952-954.6 Dalton BE Kohm AC Miller LE Block JE Poser RD Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
description	Brian E Dalton,1 Andrew C Kohm,2 Larry E Miller,3,4 Jon E Block,4 Robert D Poser21Tri-State Neurological Surgeons, Erie, PA, 2DFINE, Inc, San Jose, CA, 3Miller Scientific Consulting, Inc, Arden, NC, 4The Jon Block Group, San Francisco, CA, USAPurpose: Traditional balloon kyphoplasty (BK) is a common treatment for symptomatic vertebral compression fractures. The purpose of this study was to compare a novel vertebral augmentation technique, radiofrequency-targeted vertebral augmentation (RF-TVA), to BK for restoration of vertebral height, cavity creation, and polymethylmethacrylate (PMMA) delivery and interdigitation into the surrounding trabeculae.Methods: This ex vivo biomechanical pilot study utilized 16 osteoporotic cadaveric vertebral bodies in a standardized fracture model to compare unipedicular RF-TVA (n = 8) to bipedicular BK (n = 8). Four specimens from each group were tested in loaded and unloaded conditions. All specimens were imaged, assessed for height restoration, and sectioned to observe PMMA distribution. A subset of specimens underwent computed tomography scanning to assess cavity creation and trabecular architecture prior to cement delivery.Results: Anterior height restoration was greater with RF-TVA (median: 84%, interquartile range: 62%–95%) compared to BK (median: 69%, interquartile range: 60%–81%), although the difference did not achieve statistical significance (P = 0.16). Anterior height restoration was numerically greater under loaded (median: 70% versus 66%) and unloaded (median: 94% versus 77%) conditions with RF-TVA versus BK. RF-TVA produced more discrete cavities and less native trabecular destruction compared to marked trabecular destruction observed with BK. RF-TVA consistently showed a well-identified focal area of PMMA with an extensive peripheral zone of PMMA interdigitation, providing mechanical interlock into the adjacent intact trabecular matrix. In contrast, BK yielded little evidence of PMMA interdigitation beyond the boundaries created by the balloon tamp due to the crushed trabecular bone peripherally.Conclusion: RF-TVA achieves favorable vertebral height restoration with targeted PMMA delivery and less trabecular destruction compared to BK. RF-TVA has potential clinical utility in the aging population with painful osteoporotic vertebral fracture.Keywords: balloon kyphoplasty, fracture, polymethylmethacrylate, radiofrequency targeted, vertebral augmentationErratum for this paper has been published
format	article
author	Dalton BE Kohm AC Miller LE Block JE Poser RD
author_facet	Dalton BE Kohm AC Miller LE Block JE Poser RD
author_sort	Dalton BE
title	Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
title_short	Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
title_full	Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
title_fullStr	Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
title_full_unstemmed	Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
title_sort	radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/d9125242fb294fa2b4214dbe0f214b30
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Radiofrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty: radiographic and morphologic outcomes of an ex vivo biomechanical pilot study

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