Flexible memory-alloy instrumentation for unilateral transpedicular kyphoplasty and guided cement augmentation of the thoracic spine

The purpose of this novel study was to investigate the feasibility of unilateral transpedicular balloon kyphoplasty particularly of the upper thoracic vertebrae using an 11- gauge balloon and cement inserter, and to study the morphological parameters of the thoracic spine pedicles. We used four fresh frozen cadaveric thoracic spines with intact rib cages and skin for kyphoplasty from T1 to T12 vertebrae under C-arm fluoroscopy. The most limiting width of the pedicles 2.46+/-0.32mm was in the middle levels (T5-T8). The absolute minimum height of the pedicles was at T1 (3.80-3.87mm). All regions of the vertebral body were effectively targeted for cement augmentation. The average cement load of all the vertebral bodies was 43,22%. Using the kyphoplasty technique in combination with the pre-bent 11mm memory-alloy cement inserter allowed targeting of the desired position of the vertebral body for effective vertebral body cement augmentation.