Time from Discovery to Procedure Impacts Pain Reduction but not Radiographic Correction for SpineJack Treatment of Vertebral Compression Fractures

Introduction: Vertebral compression fractures (VCFs) are associated with a significant burden of pain, functional loss, and associated cost. They are an increasingly common clinical entity with aging population. There exists a clinical need to identify and study treatment approaches for compression deformities that minimize patient pain and restore function. SpineJack is a novel device aimed at restoring lost vertebral height in this population.

Methods: Patients undergoing SpineJack thoracolumbar compression fracture correction between February 2021 and September 2022 at our institution were enrolled in our cohort. Outcome data including follow-up radiographs, readmissions, new fractures, and pain were collected. Categorical variables were compared using Fisher’s exact tests. The cohort was split into acute ( < 6-week) and chronic (>6 weeks) groups that were compared using t-tests or Mann-Whitney U tests, whereas respective paired tests were used in comparing pre- and post-treatment groups. Spearman’s rank correlation tests were used to compare continuous variables.

Results: 23 patients with 28 fractured vertebrae were included (78% female, median age 74). The most common mechanism of injury was fall (59%). The most common level was L1 (36%). There was a significant improvement in anterior compression, posterior compression, and local kyphotic angle following SpineJack correction procedures (mean 16.2 vs 19.1, 21.6 vs 23.7, and 15.6 vs 12.5, all p < 0.001).
Baseline factors between acute and chronic groups were not significantly different, except for age (mean 82 vs 67, p < 0.01). At no time point after fracture discovery did waiting time impact the degree of VCF correction (p > 0.05). Re-operation, discharge disposition, and adjacent fractures were also not impacted by waiting. Less time from discovery to surgery was significantly associated with reduction in pain at the 1-day, 7-day, 3-month, and 6-month follow-up time (p < 0.05). The degree of correction did not correlate with the improvement in pain (p > 0.05).

Conclusion : The use of SpineJack in thoracolumbar fracture is a promising option for thoracolumbar compression fracture correction. While there appears to be a significant pain benefit to treating these fractures earlier, there does not seem to be an association between the degree of correction and fracture age.