European Spine Journal - 2026-08-10 - Journal Article
Sphereplasty with 3D porous titanium microspheres for thoracolumbar vertebral compression fractures: analysis of clinical efficacy and safety profile of a novel technique.
Barbagallo GMV, Cammarata G, Grasso E, Basile A, Maugeri A, Buscema G, Fiumanò G, Agodi A, Servadei F, Certo F
Topics
Key Takeaway
PTM-based Sphereplasty for AO Spine A1/A3 thoracolumbar VCFs reduced median NRS from 8.0 to 4.0 and ODI from 66.35% to 28.45% at median 334-day follow-up, with significant anterior and middle vertebral body height restoration.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study evaluated clinical and radiological outcomes of PTM-based Sphereplasty in 52 patients with AO Spine A1 and A3 thoracolumbar VCFs. NRS improved from 8.0 to 4.0 and ODI from 66.35% to 28.45% (both p<0.001); anterior VBH increased from 19.52 to 21.65 mm and middle VBH from 17.49 to 21.20 mm. Kyphosis angle improved acutely (6.9° to 5.5°) but partially recurred to 7.71° at final follow-up, while wedge angle was durably maintained at ~5°.
Key Limitation
The absence of a concurrent PMMA kyphoplasty control group renders all efficacy and safety comparisons indirect, preventing any conclusion that Sphereplasty is superior or equivalent to established augmentation techniques.
Original Abstract
PURPOSE
Porous Titanium Microspheres (PTM)-based Sphereplasty has been recently proposed as a novel vertebral augmentation technique for thoracolumbar Vertebral Compression Fractures (VCFs), potentially promoting bony fusion and reducing long-term complications. This study aims to evaluate the clinical efficacy and safety of PTM-based Sphereplasty for the treatment of post-traumatic thoracolumbar VCFs and compared the results with data from the literature on standard PMMA-based kyphoplasty.
METHODS
Fifty-two patients (32 females), treated with PTMs Sphereplasty for 57 post-traumatic AO Spine A1 and A3 thoracolumbar VCFs, were prospectively enrolled. Data on demographics, fracture types, surgical details, pain scores (NRS) and disability (ODI) were analyzed. Imaging included x-ray, MRI and CT. Vertebral Body Height (VBH), Wedge Angle (WA) and Kyphosis Angle (KA) were measured.
RESULTS
Median age was 62.7 years and median follow-up was 334.0 days. Median NRS scores decreased from 8.0 to 4.0 (p < 0.001) and ODI improved from 66.35% to 28.45% (p < 0.001). Radiological evaluation demonstrated median KA values of 6.9° preoperatively, 5.5° postoperatively and 7.71° at final follow-up (p = 0.026). WA decreased from 8.4° to 5.0° and 5.1°, respectively (p < 0.001). Anterior and middle VBH improved significantly, from 19.52 to 21.65 mm (p = 0.003) and from 17.49 to 21.20 mm (p < 0.001), whereas there was no clinically relevant change in cranial and caudal VBHs.
CONCLUSION
Sphereplasty is a safe and effective treatment for post-traumatic thoracolumbar VCFs, providing primary stability, pain relief and functional improvement. PTMs may represent a promising alternative to PMMA kyphoplasty, promoting bony fusion and reducing long-term complications.