Compression Fracture Reduction Kyphoplasty Height Restoration Cord Compression Improvement

Symptomatic Cord Compression is an absolute contraindication to kyphoplasty.  However, retropulsion is not, and can even make things better and avoid an operation — as this case shows. The problem is that its unpredictable and one has to be extremely careful…

Patient presents with severe acute T11 fracture.  There are some chronic ones also — very bad T9 and just bad T10

Pre-procedure CT scan

MRI and CT on the top.  Lateral projection xray and DYNA CT reconstruction during kyphoplasty on bottom.  There is tremendous spontaneous reduction of T11 compression fracture — due to prone positioning.   Also notice fracture of the pedicle

Sagittal views of DYNA CT — height restoration, pedicle fractures

Post kyphoplasty DYNA CT — intentional extension of cement into the pedicles to help stabilize the fracture

Post-kyphoplasty MRI — reduction of posterior fragment extension into the spinal canal with improved cord compression

Does not happen every day — one could not tell for example from the CT or MRI how much reduction, if any, would happen in prone position.  But, if it does, the results can be excellent