Abstract

Vertebral compression fracture (VCF) is a serious disaster arising from osteoporosis or trauma. Vertebroplasty and kyphoplasty are the common treatment strategies for vertebral body (VB) augmentation but reveal many complications. A newly designed implant should be considered for fracture healing and restoration of VB height, so we have developed an Intra-Vertebral Expansible Pillar (I-VEP, Aaxter, Taiwan) to strengthen the collapsed VB. Totally, 32 cases were selected for this instrumentation since Jan 2006 to June 2008. The age ranged from 60 to 82 years old, and most of them were women. Surgery was done under general anesthesia and prone position. The pedicle screws were applied or not, and the I-VEPs are inserted to the collapsed VB via bilateral pedicles. The exact positions were checked by fluoroscopy. Posterolateral fusion was done with bone graft. The results revealed that all the patients had expected correction of kyphosis and restoration of the vertebral height. The intractable back pain also had been improved. The concept of I-VEP is like steel bar incorporating with cement for constructing a building. The larger size of I-VEP, the higher anterior support of VB will be accomplished. The expansible function maximizes the augmenting height of collapsed VB. The safe-zone concept ensures the intact inferior and medial cortex without injury of root and spinal cord. The bursting fractures would be accepted in the lateral and superior cortex of pedicles. Augmentation by inserting expansible pillars and bone grafting is an acceptable alternative for treating the collapsed VB.