The radiographic characterization of burst fractures of the spine

A retrospective review of 75 burst fractures of the spine was performed to define the radiographic features found on high-resolution CT, polytomography, and plain radiography and thereby allow full characterization of this uncommon spinal injury. Characteristic components of the injury include: centripetally oriented disruption of the vertebral body, unilateral or bilateral laminar fractures that abut the spinous process, marked anterior wedging, vertically oriented vertebral fracture emanating from the basivertebral foramen, increased interpediculate distance, and significant spinal canal narrowing by characteristic retropulsed fragments. Nearly all bursts occurred from T9 to L5; double bursts were present in less than 10% of cases. The usually present neurologic deficit nearly always corresponded to the level of the burst rather than to the frequently found noncontiguous associated spine fracture. Recent literature suggests that these complex fractures, which were initially thought to represent stable injuries, are often unstable. A subcategorization of burst fractures and their variants is proposed to explain this instability. An approach to the radiographic diagnosis of the spinal burst is proposed, and plain film clues to distinguish the burst fracture from the more common compression fracture are discussed. Representative cases are illustrated.     

Spine fractures in falling accidents: analysis of multidetector CT findings

The purpose of the present study was to assess incidence, fracture type, and location of spine fractures due to falls. All emergency room CT requests during a time period of 26 months were reviewed retrospectively. Patients who had fallen or jumped and were initially examined with multidetector CT (MDCT) were included. The MDCT studies were evaluated by two radiologists for trauma location, fracture type, and multiple level involvement. A total of 237 patients (184 males, 53 female, age range 16–86 years, mean age 42 years) met the inclusion criteria. A total of 203 vertebral fractures were seen in 127 patients. Burst fracture (n=78) was the most frequent type of trauma, usually located in the thoracolumbar junction (50%). Also, compression fracture (n=52) was most common in the thoracolumbar junction (39%). Posterior column fracture (n=52) was most frequently detected in the cervical spine (40%). Multiple-level spine fractures were seen in 41 (32%) of the injured patients, of which 12 (29%) had fractures at noncontinuous levels. With increasing height the overall incidence of fractures increased, and burst fractures and multiple level spine fractures became more frequent. Age had no effect on fracture type or location. Spine fractures due to falls are common. Burst fracture is the most common fracture type and most frequently seen in the thoracolumbar junction. Multiple-level fractures were seen in 32% of the cases, of which 29% were seen at noncontinuous levels. Serious spine fractures are seen in all falling height and age groups.     

经伤椎椎弓根植骨置钉后路内固定治疗胸腰椎爆裂性骨折

目的：探讨经伤椎椎弓根植骨置钉结合后路椎弓根短节段内固定治疗胸腰椎爆裂性骨折的可行性及临床效果。方法回顾性分析东营市河口区人民医院2008年12月～2011年11月采用经伤椎椎弓根植骨置钉椎结合后路椎弓根短节段固定治疗单节段胸腰椎爆裂性骨折患者36例,男性24例,女性12例;年龄26～62岁,平均39.2岁。损伤节段： T119例,T1213例,L110例,L23例,L31例;致伤原因：道路交通伤15例,高处坠落伤15例,重物砸伤6例。神经功能情况按Frankel分级： B级2例,C级13例,D级6例,E级15例。通过对术前、术后即刻以及终末随访时影像学指标、神经功能的比较分析临床疗效。结果36例均获得随访,随访时间14～60个月,平均21.6个月。术后1.5年随访时按Frankel评价标准均有1～3级不同程度恢复,腰背痛视觉模拟评分（ VAS）较术前明显改善。患者均获得骨性融合,随访影像学检查示椎管狭窄率、Cobb角、伤椎楔变角、下间隙角、上间隙角、伤椎前缘压缩率、伤椎后缘压缩率较术前明显恢复,无内固定松动或断裂等并发症发生。结论经伤椎椎弓根植骨置钉结合后路椎弓根短节段固定治疗胸腰椎骨折能够较好地重建伤椎高度,有效维持伤椎的三柱稳定性,降低了内固定失败发生率,是一种安全、有效的手术方式。     

螺旋CT在胸腰段脊椎爆裂骨折中的应用价值

目的探讨螺旋CT多平面重建、三维立体成像在胸腰段脊椎爆裂骨折的应用价值。方法回顾性分析96例102个脊椎爆裂骨折的螺旋CT表现。结果在102个椎节中,累及T12～L288个椎节,占总数的86.27%,L1受累最高,达49个椎节,占48.03%;椎管狭窄的程度与伴发神经损伤有关：轻度与中度椎管狭窄两者间神经损伤有显著差异（χ2=8.72,P〈0.05）;中度与重度椎管狭窄两者间有非常显著性差异（χ2=18.18,P〈0.05）。结论螺旋CT扫描能很好地显示脊椎爆裂骨折和椎管狭窄的程度,是诊断胸腰椎爆裂骨折的重要方法,对帮助制定治疗方案有重要作用。     

胸腰段脊椎爆裂骨折的CT诊断(附70例分析)

目的 研究胸腰段脊椎爆裂骨折的CT表现和椎体后缘的后移碎骨片引起椎管狭窄与神经损伤之间的关系。资料与方法 回顾性分析70例72个椎体爆裂骨折的CT表现，其中有2例为2个脊椎爆裂骨折。所有患者CT扫描层厚、层距均为5mm。结果 脊椎胸腰段爆裂骨折的CT表现如下：（1）椎体向心性爆裂；（2）碎骨片向后移位导致椎管狭窄；（3）椎基静脉孔垂直矢状向骨折；（4）单侧或双侧椎板骨折；（5）部分伴随横突、棘突、关节突和／或椎体骨折。椎管狭窄和程度与神经损伤有关。结论 CT扫描能很好地显示脊椎爆裂骨折和椎管狭窄的程度，是诊断胸腰椎爆裂骨折的重要方法，并对帮助制订治疗方案起着重要作用。     

胸腰椎外伤性脊髓空洞症的特征及其意义

目的 回顾分析胸腰椎外伤性脊髓空洞症的症体、体征及影像学改变，分析其发病机制及临床意义。方法 本组14例，男13例，女1例；年龄28－56岁。脊柱骨折部位为T111例，T127例，L6例。11例为爆裂型暴折，3例为骨折脱位。其中5例行前路减压、植骨融合、内固定术；1例行后路减压、植骨融合、内固定术；其余8例对症处理，未行手术治疗。结果 本组14例于伤后6个月－4年行胸腰椎MRI检查时被确诊为脊髓空洞症，空洞开头呈洞形6例，椭圆形5例，不规则3例。患者常出现以下症状；疾痛（78．6％，11／14）、下肢肌力减退（64．3％，9／14）、下肢痉挛性增加（42．9％，6／14）、感觉丢失或减退（42．9％，11／14）、下肢运动协调能力降低（14．3％，2／14）、自主神经症状（7．1％，1／14）等。结论 脊髓损伤神经功能稳定后一段时间，出现下肢肌力减退等新的神经症状应高度怀疑脊髓空洞症的发生。     

经Wiltse 肌间隙入路置入椎弓根螺钉固定治疗多节段非连续性胸腰椎骨折的疗效观察

目的观察经Wiltse肌间隙入路置入椎弓根螺钉治疗多节段非连续性胸腰椎骨折的临床疗效。方法回顾性分析陆军军医大学大坪医院脊柱外科2016年9月-2019年5月收治的24例多节段非连续性胸腰椎骨折的病例资料,男性17例,女性7例;年龄29~63岁,平均44.7岁。致伤原因:高处坠落伤17例,道路交通伤7例。术中采用后路经Wiltse入路置入椎弓根螺钉固定多节段非连续性胸腰椎骨折,统计患者的手术时间、术中出血量、术后引流量、VAS评分、ODI评分情况以及术前、术后、末次随访时关键骨折椎体Cobb角等临床资料。结果患者均顺利完成手术。手术时间90~150min,平均120.8min;失血量100~240mL,平均150.6mL;术后第1天引流量为70~120mL,平均为100.5mL;术前VAS评分平均为7.6分,术后为2.3分,疼痛明显缓解;术前ODI指数平均为26.7分,术后为8.2分;术前关键骨折椎体Cobb角平均为27.8°,术后1周为9.1°,末次随访时为9.9°。术后随访3~32个月,患者症状均明显缓解,术后无医源性脊髓损伤发生,脊柱活动度正常。结论经Wiltse肌间隙入路置入椎弓根螺钉固定治疗多节段非连续性胸腰椎骨折能有效减少手术创伤,加速患者恢复,临床疗效明确。     

经伤椎椎弓根椎体内植骨结合椎弓根螺钉内固定治疗胸腰椎爆裂骨折的长期疗效观察

目的研究经伤椎椎弓根椎体内植骨结合椎弓根螺钉治疗胸腰椎爆裂骨折的长期疗效。方法在89例胸腰椎爆裂骨折中,75例获得随访,其中52例接受了经伤椎椎弓根椎体内植骨结合椎弓根螺钉内固定手术,23例则采用了单纯后路复位、椎弓根螺钉内固定、后外侧植骨融合术。观察指标包括神经功能改善、Cobb角改变、伤椎与正常椎高度比、VAS疼痛评分改变等。结果两组患者在神经功能改善、Cobb角改变、伤椎与正常椎高度比、VAS疼痛评分改变方面无显著性差异（P〉0.05）,但第2组患者内固定失败率较高。结论经伤椎椎弓根椎体内植骨结合椎弓根螺钉内固定能很好恢复伤椎的高度,避免后凸畸形的复发,同时有助于临床症状的改善,而且内固定失败率较低。     

胸腰椎前入路手术的操作技术改进

目的总结胸腰椎前入路手术改进经验,以减少胸腰椎骨折前入路术中失血量,减轻创伤,提高椎体置钉成功率。方法 除T12、T4椎体爆裂骨折外,术中不需切断膈肌角,仅结扎爆散椎体术侧椎体血管,切除骨折椎相邻上、下椎间盘后椎体置钉,取髂骨,再切除椎体行椎管减压,撑开骨折间隙髂骨块结构性植骨,置放钢板矫形加压锁定。结果采用改进技术,治疗胸腰椎骨折93例,其中新鲜骨折82例,术中失血400～800ml,平均560ml,手术时间2．5～3小时;陈旧性骨折11例,术中失血800～1200ml,平均1080ml,手术时间3．5～4小时。置钉时腰动脉损伤4例4条,根据作者拟定标准,置钉位置正确90例,不满意3例。结论胸腰椎前路操作技术改进,与以往报告相比,可保护椎体血供,减少术中失血,有利于植骨愈合,减少了并发症,缩短手术时间,对陈旧性骨折患者效果更佳。     

New symptomatic compression fracture after percutaneous vertebroplasty at the thoracolumbar junction

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the risk factors for new symptomatic vertebral compression fractures after vertebroplasty at the thoracolumbar junction. MATERIALS AND METHODS: We conducted a retrospective analysis of 53 patients treated with percutaneous vertebroplasty at the thoracolumbar junction (T12, L1). The follow-up period was 15-27 months. The occurrence of new symptomatic vertebral compression fractures was recorded after vertebroplasty. We evaluated patient age and sex, amount of injected cement, vacuum clefts in the collapsed bodies, initial wedge angle of the compression fracture, change of the wedge angle after vertebroplasty, intradiskal cement leak, and percentage of height restoration of the vertebral body. In this report, we surveyed the possible risk factors for new symptomatic vertebral compression fractures. RESULTS: Thirty-nine (74%) of the 53 patients had fluid and/or air in the compression fracture at the thoracolumbar junction (T12, L1). Eight (20.5%) of the 39 patients with vacuum clefts had new symptomatic compression fracture after vertebroplasty between 1 month and 4 days after surgery to 23 months and 4 days after surgery. The patients with new symptomatic compression fracture had higher initial wedge angle and wedge angle change (more than 7 degrees ) after vertebroplasty than those without fractures; these data were considered statistically significant. CONCLUSIONS: The incidence of vacuum clefts in the compression fracture at the thoracolumbar junction is high (74%). The severity of initial wedge angle and wedge angle change affects the incidence of new symptomatic compression fracture.     

脊柱后侧韧带群损伤的MRI诊断

目的探讨急性期胸腰椎外伤病人脊柱后侧韧带群(PLC)损伤的MRI表现及其临床意义.方法回顾分析60例急性期胸腰椎外伤病人MRI,观察PLC损伤与各型脊柱骨折的关系及其MRI表现.结果PLC损伤共20例(33%).屈曲压缩型骨折、爆裂型骨折及脱位型骨折PLC损伤的发生率分别为21%、38%及70%.MRI表现为正常低信号韧带中断,局部呈斑片状短T1、长T2或中等T1、长T2信号.PLC损伤以棘上韧带最好发(19例),其次为棘间韧带(18例)、黄韧带(7例)及椎小关节囊(4例).18例病人为两种或两种以上韧带同时损伤.结论MRI可以明确脊柱外伤时有无PLC损伤以及明确PLC损伤的范围和程度.     

脊柱胸腰段爆裂性骨折术后椎弓根螺钉断裂原因分析及其对策

目的：分析脊柱胸腰段爆裂性骨折术后椎弓根螺钉断裂的原因及其对策。方法回顾分析我院自2005年5月～2011年8月286例脊柱胸腰段爆裂性骨折术后椎弓根螺钉内固定后发生断裂17例的临床资料,男性14例,女性3例,其中24～44岁13例,45～60岁4例。未使用横杆组断钉7例,使用横杆组10例;伤椎给予椎弓根螺钉固定断钉7例,未固定10例;椎间植骨组断钉1例,后侧植骨组断钉7例,未植骨断钉9例;椎板切除减压14例,未切除减压3例。结果在螺钉断裂的各独立因素中,性别对于断钉未见明显差别（ P＞0．05）,而年龄＜45岁、未使用横杆固定、伤椎未给予固定、椎板切除减压、未植骨和爆散面积＞50％均为椎弓根螺钉断裂的高危的因素,均具有统计学意义（ P＜0．05）。结论对于脊柱胸腰段爆裂性骨折患者,应针对高危因素采取个体化的措施,进行有针对性的治疗和保护,避免术后椎弓根螺钉断钉发生。     

绝经期女性胸腰椎后凸与椎体压缩骨折相关性分析

目的探讨绝经期女性骨质疏松骨折的临床特点,以及胸腰段脊柱力线对骨折发生的风险分析。方法本研究为病例对照研究,收集自2013年1月至2015年6月因骨质疏松性压缩骨折在北京积水潭医院住院,并行椎体成形术的绝经期女性患者396例(研究组),平均年龄64岁(55~72岁);对照组选取因下腰椎退行性疾病住院手术的患者271例,平均年龄62岁(55~84岁)。记录所有患者入院时的年龄、体质量指数(BMI)、骨密度定量CT(QCT)、骨折椎体。利用站立位X线影像测量胸腰段(T11~L2)矢状位和冠状位的Cobb角。利用患者胸腰段椎体的平均Cobb角,修订并推算骨折前患者T11~L2的矢状位和冠状位Cobb角。分析胸腰段骨质疏松性骨折的临床点和危险因素。结果研究组患者中,T11椎体骨折患者69例(19.6%),T12椎体骨折153例(43.5%),L1椎体骨折174例(49.4%),L2椎体骨折70例(19.9%)。研究组和对照组患者的年龄和BMI差异无统计学意义(P>0.05)。研究组患者修订后的胸腰段矢状位Cobb角为(13.6°±7.6°),对照组为(5.9°±6.0°),两组间差异有统计学意义(P<0.01)。研究组患者修订后胸腰段冠状位Cobb角为(0.4°±4.0°),对照组为(0.1°±4.1°),两组间差异无统计学意义(P>0.05)。使用ROC曲线和尤登指数计算胸腰段矢状位Cobb角,对于胸腰椎骨质疏松性骨折的最佳分界值为7.5°,OR值为7.6(95%可信区间为2.5~22.8)。结论胸腰段矢状位后凸会增加骨质疏松性骨折的风险,后凸Cobb角度>7.5°时,骨折风险增加7倍,但冠状位的侧弯不增加骨折的风险。     

经皮椎弓根钉棒跨伤椎内固定治疗胸腰椎骨折的临床研究

目的探讨经皮椎弓根钉棒跨伤椎内固定治疗胸腰椎骨折的临床效果。方法回顾性分析2015年3月-2018年1月周口市中心医院骨关节外科收治的99例胸腰椎骨折患者的临床资料,男性54例,女性45例;年龄24~63岁,平均41.0岁;致伤原因:高处坠落伤25例,摔伤37例,道路交通伤37例;骨折部位:T1123例、T1222例、L127例、L227例;骨折类型:压缩性骨折51例,爆裂性骨折48例。将入选的患者根据手术方式的不同分为A组(n=53,开放椎弓根钉棒系统治疗)和B组(n=46,经皮椎弓根钉棒系统治疗)。比较两组患者围术期指标、功能改善、疼痛情况、影像学指标情况,记录两组术后并发症发生率。结果 B组患者手术时间[(81.6±5.3)min vs.(102.8±4.8)min]、住院时间[(8.1±1.4)d vs.(11.1±1.9)d]短于A组,术中出血量[(52.8±4.1)mL vs.(66.6±3.1)mL]少于A组(P<0.05);B组术后1、3、12个月VAS评分均低于A组[(3.6±0.4)分vs.(4.6±0.4)分,(2.4±0.4)分vs.(3.5±0.4)分,(0.9±0.2)分vs.(1.8±0.2)分,P<0.05],Oswestry功能障碍指数(ODI)均低于A组[(25.1±3.3)分vs.(33.2±3.9)分,(16.9±2.4)分vs.(23.7±3.7)分,(9.2±1.1)分vs.(15.8±2.2)分,P<0.05]。两组患者术后即刻、术后12个月后凸Cobb角较术前下降,伤椎前缘相对高度较术前升高(P<0.05);但A、B两组术后即刻、术后12个月后凸Cobb角、伤椎前缘相对高度比较差异无统计学意义。两组并发症发生率比较差异无统计学意义(15.09%vs. 10.87%,P>0.05)。结论相对于开放椎弓根钉棒系统治疗,经皮椎弓根钉棒系统治疗胸腰椎骨折,在获得同等治疗效果的基础上,具有创伤小、术后恢复快等优势,同时还可有效改善术后疼痛及腰椎功能,不增加术后并发症发生率,临床应用价值较高。     

外伤性胸腰椎骨折的X线和CT诊断

目的探讨X线和CT在外伤性胸腰椎骨折中的诊断价值。材料和方法57例胸腰椎骨折均行X线和CT检查。结果57例74个椎体骨折中单椎体骨折43例,多椎体骨折14例。爆裂型骨折45个椎体,压缩型骨折21个椎体,骨折脱位型9个椎体。骨折发生于前柱10个椎体,前中柱22个椎体,前中后柱39个椎体,中后柱2个椎体,前后柱1个椎体。结论X线平片对外伤性胸腰椎骨折有一定的价值,但CT在显示椎体三柱结构,骨折线,小关节脱位,椎管狭窄程度,脊柱稳定性,判断脊髓损伤等有明显优势。     

胸腰椎爆裂型骨折的CT诊断及其与X线平片对比分析

目的 比较CT扫描与X线平片对胸腰椎爆裂型骨折的诊断价值。方法 回顾性对照分析78例胸腰椎骨折的X线平片与CT表现。结果 78例96节胸腰椎爆裂型骨折中,单椎体骨折者64例,多椎体骨折者14例。以CT扫描为诊断标准,近30％X线平片将爆裂型骨折误诊为单纯压缩型骨折。结论 X线平片虽是脊柱损伤的基本检查手段,但部分病例X线平片较难区分单纯压缩型骨折和爆裂型骨折。CT检查能明确爆裂型骨折类型、判断脊柱失稳及椎管受累程度,对X线平片观察发现有压缩型骨折者应作常规CT扫描。     

胸腰段爆裂骨折伴脱位的手术治疗及疗效分析

目的 探讨后路手术治疗胸腰段脊柱爆裂骨折伴脱位的疗效. 方法 选择2005年10月-2008年3月收治的胸腰段爆裂骨折合并骨折脱位患者22例,其中男17例,女5例;年龄18～56岁.受伤节段为T12～L2,骨折椎体压缩1/4～3/4,上位椎体向前脱位程度为25%～50%.手术均在伤后2周内完成.将患者按数字随机法分为两组:组Ⅰ:采用2椎体4椎弓根钉置入复位固定,组Ⅱ:采用3椎体6椎弓根钉置入复位固定.观察并比较两组手术时间、失血量、后凸角、神经功能以及腰痛评分(low back outcome score,LBOS). 结果 术后随访12～36个月,组Ⅱ手术时间长于组Ⅰ,但并没有明显增加术中失血量.在矫正率、矫正丢失及内固定失败方面,组Ⅱ均明显优于组Ⅰ.两组术后神经功能以及LBOS评分差异无统计学意义. 结论应用3椎体6枚椎弓根螺钉置入复位固定治疗胸腰段爆裂骨折伴脱位是一种安全有效的方法 .     

全面部骨折38例临床分析

目的探讨全面部骨折的临床特点及治疗方法。方法收集我院2003年10月~2008年10月收治的38例全面部骨折患者病历资料,对致伤原因、伤情特点、治疗方法进行分析。结果致伤原因以交通伤为主,占全部骨折的86.8%,其中摩托车伤占交通伤比例的57.6%,骨折类型除上下颌骨骨折外,鼻骨是最常见的骨折部位,多成粉碎性,其次为颧骨。下颌骨多呈线形骨折,单处多见,上颌骨以双侧骨折、颧上颌缝分离、上颌窦前壁粉碎性骨折、双侧上颌骨中缝分离为主要的骨折类型。手术方法遵循从下到上,从外到内的骨折复位固定顺序,重建咬合关系和恢复面部外形,手术效果良好。结论目前全面部骨折以上颌骨、鼻骨、颧骨、下颌骨多发骨折为主,遵循建议的治疗方法可获得良好的效果。     

Spinous process fractures in osteoporotic thoracolumbar vertebral fractures

Objectives

To evaluate the incidence and pattern of spinous process fractures (SPFs) in patients with osteoporotic compression fractures (OCFs) of the thoracolumbar spine.

Methods

Spinal MRI or CT of 398 female patients (age range 50–89 years, mean age 70 years) who had OCFs in the thoracolumbar spine were retrospectively reviewed. The incidence, location and imaging results for the SPFs were evaluated.

Results

Of the 398 patients who had thoracolumbar OCFs, 14 (3.5%) had SPF. In six patients with single compression fractures, the SPF occurred at the level just above the vertebral compression fracture. In six out of seven patients with multiple continuous compression fractures, the SPF occurred just one level above the uppermost level of the compression fracture. The remaining one patient who had thoracolumbar spinal fixation at T12–L2 with continuous compression fractures in T12–L5 had a SPF in L2. In one patient who had multiple compression fractures in discontinuous levels (fractures at T10 and L1, respectively), the SPF occurred at T12. The directions of the fractures were vertical or oblique vertical (perpendicular to the long axis of the spinous process) in all cases.

Conclusion

In the presence of an OCF in the thoracolumbar spine, a SPF was found in 3.5% of cases, and most of the fractures were located just one level above the compression fracture. Therefore, in patients who have OCF, the possibility of a SPF in the level just above the compression fracture should be considered.Osteoporosis is a common disease owing to an increase in the population of older people. Osteoporosis is a disease that induces bone fragility, caused by a decrease in trabecular bone, and the resulting fracture is called an insufficiency fracture. The most common osteoporotic compression fractures occur in the spine, sacrum, pubis, femoral neck and wrist [1].Although the most common methods for imaging vertebral fractures are still spinal radiographs, benign spinal compression fractures are commonly detected by MRI or CT on osteoporotic patients with back pain. Sometimes, it is difficult to differentiate a benign spinal compression fracture from a malignant cause of the spinal compression fracture. However, in most cases, a benign spinal compression fracture shows some specific features: a low-signal-intensity band on T₁ and T₂ weighted images, spared normal bone marrow signal intensity of the vertebral body, retropulsion of a posterior bone fragment and multiple compression fractures [2]. A relationship between osteoporosis and benign spinal compression fractures, including insufficiency fractures, has been reported. A study examining the relationship between benign compression fractures of the spine and insufficiency fractures of the sacrum has also been reported [3]. However, there have been few reports of spinous process fractures in the osteoporotic spine [4]. Moreover, there have been no studies examining the relationship between spinous process fractures and benign compression fractures of the spine.We have noted index cases of spinous process fractures in certain patients with osteoporotic compression fractures. There has been no report of spinous process fractures in patients with osteoporotic compression fractures. The aim of this study was, therefore, to evaluate the relationship between osteoporotic compression fractures and spinous process fractures in patients with osteoporosis.     

Safety and Effectiveness of Expandable Intravertebral Implant Use for Thoracolumbar Burst Fractures

PurposeTo determine the safety and effectiveness of an expandable intravertebral implant (Spinejack; Stryker, Kalamazoo, Michigan) as a treatment option for patients with thoracolumbar spine burst fractures without fracture-related neurologic deficit.Materials and MethodsImaging studies before and after expandable intravertebral implantation and medical records of 33 patients, 11 (33.3%) men and 22 (66.6%) women with an overall mean age of 71.7 years ± 8.3, were reviewed for 60 thoracolumbar Magerl Type A3 injuries secondary to osteoporosis, trauma, or malignancy. The mean follow-up time was 299 days.ResultsImplantation of an expandable intravertebral device resulted in a statistically significant reduction in bone fragment retropulsion (mean ± SD, 0.64 mm ± 16.4; P < .001), reduction in the extent of canal compromise (mean, 5.5%; P < .001), increased central canal diameter (mean ± SD, 0.71 mm ± 1.3; P < .001), and restoration of vertebral body height, with a mean increase of 5.0 mm (P < .001). However, the implantation did not result in a statistically significant kyphosis reduction (mean, 1.38°; P = .10). All patients except for 1 reported improvement in pain after surgery, with a mean improvement of 1.54 on a 4-point pain scale (P < .001). No clinically significant adverse events were reported.ConclusionsThis study suggests that expandable intravertebral device implantation is a safe and effective treatment for thoracolumbar vertebral burst fractures in patients without fracture-related neurologic deficit. Although implantation did not result in a statistically significant reduction in kyphotic angle, it offered significant improvement in pain, vertebral body height, fracture fragment retropulsion, and central canal diameter compromise.