An exciting new procedure, called the SpineJack (or spine jack), can help patients who suffer from a vertebral compression fracture (VCF). And that’s a lot of people. More than 1.5 million VCFs occur in the US each year, and 1 in every 4 post-menopausal women in the US will experience a compression fracture at some point during their life, according to this report. One in every four postmenopausal women will experience a spinal compression fracture, according to the American Association of Neurological Surgeons.
One result of vertebral compression fractures is that they can lead to a loss in height–a problem that the spine jack kyphoplasty procedure helps treat. The SpineJack system is an intravertebral reduction device that utilizes a tiny jack, similar to a car jack, to treat compression fractures. The spine jack approach is a type of kyphoplasty procedure, which is a minimally invasive surgery that involves injecting a small amount of cement into the vertebrae to treat compression fractures.
A study that compared the spine jack procedure to traditional balloon kyphoplasty found spine jack kyphoplasty to provide greater correction of kyphosis, better height restoration of compression fractures, and a reduction in refractures.
Am I a candidate for the spine jack procedure?
That’s a question I am starting to hear more frequently as more people learn about spine jack, given the benefits. Typically, I recommend the spine jack procedure for patients who have been diagnosed with a vertebral compression fracture—including those caused by kyphosis—within the past 3-4 months. The type of your compression fracture as well as your bone anatomy determine whether I would recommend the spine jack system. In most cases, younger patients in good health with average or thicker bones and average or larger compression fractures are the best candidates for spine jack kyphoplasty.
I don’t recommend the spine jack procedure for patients with small compression fractures or skinnier bones as the procedure requires more space than the traditional balloon kyphoplasty procedure. Also, older patients, those in frailer health, and those who cannot be under anesthesia would not be eligible for the procedure.
How Spine Jack Kyphoplasty Works
The best way I explain the spine jack to patients is comparing it to a tiny car jack. The spine jack, also known as spinal implant or vertebral implant, is a titanium implant that essentially looks and acts like a miniature car jack. For the procedure, I utilize image guidance and a tiny hollow needle to insert two expandable spine jacks into the compressed vertebra. Then I expand the spine jacks to restore height to the vertebra or, in the case of kyphosis, correct spine alignment issues caused by fractures. When the spine jacks are situated in the right area, I inject bone cement to keep the implants in place. This provides stability to the facture or correction to the alignment.
The minimally invasive procedure typically takes me under two hours. Many patients feel pain relief within a few hours, and most can resume normal activities within a week or two.
At your two-week post-operative follow-up appointment, I will review your post-operative X-rays and discuss next steps in recovery, such as physical therapy. At Neurosurgery One, we offer a Spine Fracture & Bone Health Clinic to help you improve your bone health after surgery. This is important to help prevent further compression fractures because if you have had one fracture, you are at high risk for more.
Balloon Kyphoplasty vs. Spine Jack Kyphoplasty
I may recommend the newer spine jack procedure if you have a compression fracture of the spine or are experiencing hunchback as a result of vertebral fractures, which is more generally and appropriately referred to as kyphosis (curvature of the spine). To be eligible for spine jack or balloon kyphoplasty, your compression fracture must have been diagnosed in the past 12 weeks.
Because balloon kyphoplasty requires less space to operate within the body and less time to complete, I recommend this procedure for patients with:
- Smaller compression fractures
- Skinnier bones
- Older patients
- Patients in more frail health
While spine jack kyphoplasty is a newer procedure with limited studies to date, research shows the procedure provides greater improvement in restoring the height of compression fractures, reduced rates of refractures after the procedure, and improved kyphosis correction. The SAKOS study showed that, when compared to balloon kyphoplasty, the spine jack system demonstrated:
- A significant reduction in adjacent level fractures.
- Significant middle vertebra height restoration at 12 months
- Greater pain score improvements at 6 and 12 months
Anecdotally, I have seen great outcomes with the procedure.
What are the pros and cons of the spine jack procedure?
As I’ve outlined above, spine jack kyphoplasty can provide improvements in compression fracture height restoration, pain reduction, reduced rates of refractures, and spinal alignment corrections.
I always remind patients that with any minimally invasive procedure, there are risks associated with anesthesia and the incision site. Any type of kyphoplasty procedure involves the use of cement to stabilize the fracture, which can limit bone movement. The spine jack procedure also takes longer than balloon kyphoplasty, which means you would be under anesthesia longer.
I stress to patients that whether you require surgery or not, improving your bone health is an important step in improving your overall outcomes. At Neurosurgery One, we offer a Spine Fracture & Bone Health Clinic to assist patients in improving your bone health before and after surgery. Unfortunately, patients with vertebral compression fractures are at increased risk of future fractures as underlying causes like osteoporosis are often present. Our bone health specialty clinic works closely with you to improve your bone health and reduce risk factors for future fractures.