Treatment of Vertebral Compression Fractures with Unilateral Intravertebral Stenting: A Retrospective Cohort Study

Abstract Background: Intravertebral device implantation is a safe and effective treatment for thoracolumbar vertebral fractures. Unilateral intravertebral stenting using a self-expanding implant can achieve anatomic reduction percutaneously through posterolateral transpedicular access. Objectives: This study analyzed clinical and radiological data on patients receiving intravertebral stenting using the expandable vertebral augment (EVA) system and reviewed currently available intravertebral implants. Materials and Methods: This was a retrospective cohort study. A retrospective review of 18 patients with vertebral compression fractures who underwent EVA intravertebral augmentation between 2020 and 2022, with an average of 1-year follow-up, was performed. Data collected pre-, postoperatively, and at final follow-up were patient-reported outcomes, including Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores; radiological assessment, including kyphotic angle; vertebral body height (anterior, middle, and posterior), and recovery rate; complications, including postoperative adjacent segment fracture and cement leakage. Results: Twenty levels of the vertebral body were operated on. The mean VAS and ODI scores, the anterior, middle, and posterior vertebral body heights, and the average kyphotic angle all showed significant improvement postoperatively. One postoperative adjacent segment fracture and one cement leakage were noted. No significant changes were found in all parameters during the postoperative period till final follow-up, indicating a sustained and favorable outcome. Conclusion: Intravertebral stenting in the treatment of vertebral compression fractures offers advantages in terms of restoring vertebral body height and kyphotic angle and has a low risk of bone cement leakage. Unilateral application of a single implant requires certain surgical experience due to a more horizontal trajectory.