The aim of the trial is to study efficacy and safety of Kyphoplasty technique with porous titanium microspheres in patients with type A vertebral body fracture (according to Magerl classification).
Randomized controlled open trial with P.R.O.B.E. design (Prospective Randomized Open, Blinded End-point) Objective: The aim of the trial is to study efficacy and safety of Kyphoplasty technique with porous titanium microspheres in patients with type A vertebral body fracture (according to Magerl classification). All consecutive eligible patients, belonging to the Neurosurgery Unit of A.R.N.A.S. Civico Hospital, in Palermo, will be included in the pilot study: 10 patients will be recruited for the treatment arm and 10 patients for the control arm. * Patients aged between 18 and 80 years. * Diagnosis of vertebral body fracture, type A (according to Magerl classification) in particular A.1, A.2 and A.3.1. * Absence of ligamentous structures lesion and / or invasion of the spinal canal, confirmed by RX TC and NMR. * Refusal to sign informed consent, * Diagnosis different from those established by inclusion criteria. * Age under 18 years. * Age over 80 years. * Presence of ligamentous structures lesion and / or invasion of the spinal canal confirmed by RX, TC and NMR. For each patient will be evaluated: * Spine RX * CT of the spinal layer (or Spine CT) * Spine MRI * Roland Morris Disability (for the assessment of low back pain) * EQ-5D (health questionnaire) * Denis Work Scale (for the assessment of working conditions) * VAS (for pain assessment) * The statistical analysis will be performed using the SPSS software vers. 12.0 (SPSS Inc., Chicago, IL, United States). The study data will be collected pursuant to and for the purposes of articles 13 and 23 of the D. L.gs. n. 196/2003. The study will be performed according to the rules established by the principles of Good Clinical Practice (as per Ministerial Decree of 07/15/97) and according to the principles gathered in the Helsinki Declaration (52 nd WMA General Assembly version, Edimburgh, Scotland, October 2000 ). The clinical practices are performed according to the most recent recommendations of the World Medical Assembly (Declaration of Helsinki, 1964, and subsequent amendments).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DEVICE_FEASIBILITY
Masking
SINGLE
Enrollment
10
Under fluoroscophy, we introduce a transpeduncolar trocar inside the vertebral body where is performed a kyphoplasty with insertion of baloons. When the dome is cretated we introduce structured titanium microspheres until the dome is full of material.
Under fluoroscophy, we introduce a transpeduncolar trocar inside the vertebral body where is performed a kyphoplasty with insertion of baloons. When the dome is cretated we introduce Polimethylmetacrilate until the dome is full of material.
Gabriele Costantino
Palermo, PA, Italy
RECRUITINGFeasibility of prototype device usage, as assessed by Change from baseline in post-surgical complication rate at 1 month.
Demonstrate if the prototype device is useful.
Time frame: 1 month post operative control
Visual analogical Scale (VAS) and changing in time.
Visual analogical Scale (VAS) from 0 to 10. Decreasing of VAS, compared to base line, will be considered a good point.
Time frame: immediate, follow-up at 1-3-6 months after trauma
Pre, Post operation Vertebra height and changing in time
Comparing Vertebra height in cm before and after surgery. Good height restoration will be considered a good point.
Time frame: immediate, follow-up at 1-3-6 months after trauma
Acquired kyphosis
Cobb angle measurement. No angle acquisition it will be considered as a good point.
Time frame: 6 months after trauma
Ostheogenesis
Induced osteogenesis investigated by Bone Scintigraphy. Osteoinduction will be considered as positive point.
Time frame: 6 months after trauma
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