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Spine (Phila Pa 1976). 2005 Aug 1;30(15):1723-30.

Can vertebroplasty restore normal load-bearing to fractured vertebrae?

Author information

1
Department of Orthopaedics, University Hospital, Stoke-on-Trent, United Kingdom.

Abstract

STUDY DESIGN:

Cadaver motion segments were used to evaluate the effects of vertebroplasty on spinal loading following vertebral fracture.

OBJECTIVES:

To determine if vertebroplasty reverses fracture-induced changes in the distribution of compressive stress in cadaver motion segments.

SUMMARY OF BACKGROUND DATA:

Vertebroplasty involves reinforcement of vertebrae by injection of cement and is now being used increasingly to treat osteoporotic vertebral fractures. However, its effects on spinal load-bearing are largely unknown. We hypothesize that vertebroplasty, following vertebral fracture, helps to equalize stress acting on the intervertebral disc and adjacent vertebral bodies.

METHODS:

Nineteen cadaver thoracolumbar motion segments (age 64-90 years) were induced to fracture by compressive overload. Specimens were then subjected to vertebroplasty, and subsequently creep loaded for 1 hour at 1.5 kN. The compressive stress acting on the intervertebral disc was measured before and after fracture, after vertebroplasty, and after creep, by pulling a pressure transducer mounted in a 1.3-mm needle across the disc's midsagittal diameter. This information was then used to calculate neural arch load-bearing. At each time point, measurements were also made of compressive stiffness.

RESULTS:

Vertebral fracture reduced motion segment compressive stiffness, decompressed the adjacent nucleus, increased stress concentrations in the posterior anulus, and increased neural arch load-bearing, all by a significant amount. Vertebroplasty partially, but significantly, reversed all of these fracture-induced changes.

CONCLUSIONS:

Vertebroplasty reduces stress concentrations in the anulus and neural arch resulting in a more even distribution of compressive stress on the intervertebral disc and adjacent vertebral bodies.

PMID:
16094273
[Indexed for MEDLINE]

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