How is the Stryker SpineJack system utilized?

Updated: Nov 12, 2019
  • Author: Gaurav Gupta, MD; Chief Editor: Justin A Siegal, MD  more...
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Answer

Answer

One of the shortcomings of percutaneous vertebroplasty and even balloon kyphoplasty is a continued rate of collapse. Osteoporotic compression fractures have a high rate of continued collapse with subsequent loss of height and the development of angulation and deformity after these procedures, which increases the risk for adjacent level fractures. The SpineJack system (Stryker Corp, Kalamazoo, MI) consists of bilateral expandable titanium implants supplemented with bone cement. This system provides more symmetric and balanced lateral and anterior support, and requires lower volumes of bone cement compared to balloon kyphoplasty. Using this system, clinicians can now achieve better pain control, restore vertebral body height, restore spinal alignment, and reduce the risk of adjacent level fractures. [20]  

The SpineJack system offers three implant kit sizes: 4.2 mm, 5.0 mm, and 5.8 mm. Each kit contains the appropriate instrumentation for the procedure, first for preparation, then for expansion and fracture reduction. The range of sizes accommodates various anatomies and fracture types. The implant expands in a craniocaudal direction and combat compression forces up to 1000N of expansion force.

A pedicle width of 0.8 mm larger than the desired implant size is recommended for safe placement. (e.g. 4.2 mm implant +0.8mm = 5mm minimum pedicle width).

Table. (Open Table in a new window)

Pedicle diameter Recommended kit
5.0–5.8 mm 4.2 mm
5.8–6.6 mm 5.0 mm
6.6 mm or greater 5.8 mm

Like a vertebroplasty, the Stryker SpineJack system utilizes a bipedicular approach to advance the access cannula to the posterior one third of the vertebral body. Then a guidewire is advanced to the midpoint of the vertebral body, then removal of the access cannula. Then following the path of the guidewire, the reamer is advanced until it is entirely within the vertebral body. Then the template is inserted to clean the implant site and verify the length of the implant. Then the spine jacks are expanded to reduce the fracture and restore anatomy. Then PMMA is advanced and good closure is obtained with adequate hemostasis.


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