Anti-RFK monoclonal antibody Made to order

Balloon kyphoplasty (BK) has emerged as a popular method for treating osteoporosis vertebral compression fractures (OVCFs). In response to several shortcomings of BK, alternative methods have been introduced, among which is radiofrequency kyphoplasty (RFK). Biomechanical comparisons of BK and RFK are very sparse. The purpose of this study was to perform a biomechanical study in which BK and RFK are compared. Each of the two study groups comprised six specimens prepared from two functional spinal units (FSUs) cut from fresh-frozen cadaveric spines (3 of T9-T11 and 3 of T12-L2). VCFs (A1.2 type) were created in the middle VB of each of the FSUs, with a height loss of 30% of the VB. After that, the specimens were subjected to cyclic compression-compression loading. The following parameters were determined: range of motion (ROM), height of the middle VB, augmentation time, cement interdigitation and cement distribution. Also, the cement layer, the trabecular bone in the augmented VB and the bone-cement interface were examined for cracks. All of these parameters were determined at various stages, namely in the intact middle VB and after its fracture, cement augmentation and subject to the cyclic loading protocol. Fractures caused a significant increase in median ROM and a significant reduction in the height of fractured VB. Cement augmentation significantly stabilized the fractures and led to partial height restoration. ROM and vertebral height, however, were not restored to the intact levels. Cyclic loading led to a further significant increase in ROM and a significant height reduction. There were no significant differences between BK and RFK in terms of any of these parameters. BK and RFK achieved similar results for fracture stabilization and restoration of the height of the fractured VB. RFK involved shorter cement augmentation time and less damage to the trabecular bone.

Study Design: Biomechanical cadaver study. Objective: The aim of the present study was to evaluate 2 different methods with respect to height restoration and preservation in a cadaver model under cyclic loading. Summary of Background Data: Standard balloon kyphoplasty (BKP) represents a well-established treatment opportunity for osteoporotic vertebral compression fractures. BKP was developed to restore vertebral height and improve sagittal alignment. Its use has grown significantly over the last 2 decades. In contrast, distinct biomechanical data are missing. Within the last few years, several alternative techniques with regard to height restoration have emerged, such as radiofrequency kyphoplasty (RFK). Methods: Twenty-five vertebral bodies of 2 female cadavers with secured osteoporosis were examined. Standardized vertebral wedge compression fractures were created. Afterward, 2 groups were randomly assigned: 12 vertebral bodies were treated with BKP and 13 vertebral bodies by RFK under a preload of 100 N. Then the vertebral bodies underwent cyclic loading (100,000 cycles, 100 to 600 N, 5 Hz). Anterior, central, and posterior vertebral body heights were evaluated by CT scans. Results: Anterior height was reduced after fracture 6.3mm (SD 3) for the BKP group and 7.2mm (SD 3) in the RFK group (P > 0.1). After treatment, the difference in the initial anterior height was 4.5mm (SD 2) for the BKP group and 4.7mm (SD 3) for the RFK group (P > 0.1). After cyclic loading, the difference was 5.3mm (SD 3) for the BKP group and 5.2mm (SD 3) for the RFK group (P > 0.1). The average cement volume used was 8.7mL (SD 1) for the BKP group and 4.8mL (SD 2) for the RFK group (P < 0.0001). Conclusions: On the basis of our results, the unipedicular RFK in osteoporotic compression fractures might represent a promising alternative for the clinical setting.