Vertebroplasty for vertebral body fracture

Vertebral body augmentation has been performed for several years and is used for pain relief and stabilization after vertebral body fractures due to trauma, osteoporosis and tumors.

The introduction of the vertebral body stent (VBS) further improves this technique. In this procedure, a balloon-mounted stent is advanced through a small cannula into the vertebral body. The stent is then opened by inflating the balloon, the balloon is then deflated and the resulting cavity is filled with cement. Compared to classical vertebroplasty, this technique offers several advantages. First, it leads to the formation of a uniform cavity, which can then be filled with cement. Secondly, the stent meshes prevent the cement from spreading too quickly and in an uncontrolled manner. This technique also offers the possibility of resetting a collapsed or reduced-height vertebral body, which has a particularly positive effect on the posture and biomechanics of the spine.

Despite these advantages, in cases of severe osteolytic or neoplastic fractures, unwanted mobilization and migration of injected cement is a possible risk. Furthermore, in patients with additional pedicle fractures, cement augmentation is not a feasible treatment option. For this purpose, in patients with large osteolytic or neoplastic fractures, additional cannulated and fenestrated screws are inserted via a percutaneous approach, in order to fix the stent and cement and to bridge the middle column in transitional fractures.

Several publications have shown that Stent-Screw-Assisted Internal Fixation (SAIF) is a safe and effective procedure for the treatment of severe osteoporotic and neoplastic vertebral fractures.