Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Balloon Kyphoplasty in Traumatic Fractures,Balloon Kyphoplasty in Traumat,Traumatic Vertebral Fractures,Typically,younger patients without osteoporosis,High blunt force fractures,Fall from roof,Car accident,Traumatic Vertebral FracturesT,Todays“gold standard”for treating traumatic VCFs,Conservative Therapy,Medication,4-6 weeks bedrest,Brace for several months,Surgical Treatment,Rods&screws,Anterior plating,Vertebral body replacement,Todays“gold standard”for tr,Why Kyphoplasty in Trauma?,Immediate pain relief,Low complication rate,Minimally invasive treatment option,Fast return to daily activities,Preservation of disc function,Prevention of disc problems and late kyphosis,Why Kyphoplasty in Trauma?Imm,Kyphoplasty in Trauma,Important differences as,compared to osteoporotic,fractures:,Treating normal bone,More burst fractures,Filling material:not PMMA!,-Instead,a CaP biomaterial,Kyphoplasty in TraumaImportant,For traumatic fractures,biomaterial Filler.not PMMA!,Biomaterial,Calcium Phosphate Cement,Viscous-toothpaste,Low pressure injection,High compressive strength,Radiopaque,Resorbs with bone ingrowth,PMMA,For traumatic fractures,bioma,Treating Traumatic Vertebral Fractures,Treatment is dependent on the type of the fracture,AO Fracture,Classification,Treating Traumatic Vertebral F,AO Classification,Fracture Classification of the thoracic&lumbar spine,A:,Vertebral body,injury with,compression,B:,Anterior&posterior elements,injury with,distraction,C:,Anterior&posterior elements,injury with,rotation,AO ClassificationFracture Clas,Indications for Kyphoplasty in treating traumatic fractures,A1.1,A1.2,A3.1,Type B,With indicated Type A fracture,In combination with Posterior Instrumentation,Type A,Indications for Kyphoplasty in,Surgical Technique,Preparation,Approach dependent on requested balloon position,Fracture location,Fractures in ventral/anterior wall,Position the balloon at least 2mm below/above the fracture plane,Surgical TechniquePreparation,Surgical Technique,Higher IBT pressures then osteoporotic cases,Handling characteristics of the biomaterial filler material are different than PMMA!,Unstable vertebral bodies should not be treated with CaP at this time,CaP should be contained completely within cancellous bone,A decent void is needed for proper CaP injection-it is better to reposition and take time with IBT expansion,Surgical TechniqueHigher IBT p,Imaging,X-Ray,AP,Lateral,CT,fracture plane,posterior wall,MRI,ImagingX-Ray,Case Studies,Case Studies,L2 fx,50 YO maleFall,treated at 5 days,Courtesy Dr.Maestretti,Fribourg,Switzerland,Pre-op lateral X-ray Pre-op lateral CT,1,L2 fx,50 YO maleFall,treate,L2 fx,50 YO maleFall,treated at 5 days,Courtesy of Dr.Maestretti,Fribourg,Switzerland,1,L2 fx,50 YO maleFall,treate,L2 fx,50 YO maleFall,treated at 5 days,Courtesy of Dr.Maestretti,Fribourg,Switzerland,Pre-op lateral Post-op lateralPost-op AP,1,L2 fx,50 YO maleFall,treate,L2 fx,50 YO maleFall,treated at 5 days,Courtesy of Dr.Maestretti,Fribourg,Switzerland,Pre-op Lateral CT,Post-op lateral CT,1,L2 fx,50 YO maleFall,treate,L2 fx,50 YO maleOne week post-op,Courtesy of Dr.Maestretti,Fribourg,Switzerland,1,L2 fx,50 YO maleOne week pos,L2 fx,22 YO maleCar accident,treated at 4 days,Courtesy of Dr.Maestretti,Fribourg,Switzerland,Pre-op lateral Post-op lateral Post-op AP,2,L2 fx,22 YO maleCar accident,L2 fx,22 YO maleCar accident,treated at 4 days,Courtesy of Dr.Maestretti,Fribourg,Switzerland,Pre-op lateral Post-op lateral,2,L2 fx,22 YO maleCar accident,L2 fx,22 YO maleCar accident,treated at 4 days,Courtesy of Dr.Maestretti,Frib