SpineJack

• Combined use of SpineJack and microwave ablation with CT and C-arm in the treatment of vertebral fractures in oncologic patients: a case- based technical note
• Applications of the SpineJack device in the surgical management of type A4 lumbar burst fractures without neurological deficit: illustrative cases
• Treatment of posttraumatic thoracolumbar fractures using SpineJack for vertebral body augmentation, a single-center retrospective, and observational cohort study of 226 cases
• Short-term clinical outcomes and safety of the SpineJack implant system for the treatment of pathological vertebral compression fractures in cancer patients: A retrospective analysis
• Early-Onset Adjacent Vertebral Fractures after Balloon Kyphoplasty and SpineJack Kyphoplasty for the Management of Single-Level Thoracolumbar Vertebral Compression Fractures
• Hybrid kyphoplasty with short-versus intermediate- and long-segment pedicle screw fixations for the management of thoracolumbar burst fractures
• A prospective multicenter randomized study comparing the SpineJack system and nonsurgical management with a brace in acute traumatic vertebral fractures: the SPICO study
• Outcomes of Treatment of Spinal Fractures with the SpineJack System

• Painful, acute or subacute VCFs (usually <3 months)
• Failure of conservative management (rest, analgesia, bracing)
• Radiological evidence of vertebral collapse (T7–L5)
• Kyphotic deformity and/or loss of anterior vertebral height
• Multiple level involvement possible

• AO Spine classification: Type A1 (wedge) and A3 (burst)
• Neurologically intact patients with axial pain
• Alternative to traditional kyphoplasty/vertebroplasty
• Minimally invasive stabilization in thoracolumbar trauma

• Metastatic vertebral lesions with mechanical instability
• Multiple myeloma-induced collapse
• Aggressive hemangiomas
• Adjunct to systemic therapy and/or radiotherapy

• Sagittal imbalance due to progressive vertebral height loss
• Adjacent segment fractures post-vertebroplasty
• Prevention of vertebral collapse in bone fragility syndromes (e.g., glucocorticoid-induced osteoporosis)
• Refracture at previously treated level

• Active local or systemic infection
• Severe coagulopathy or uncorrectable bleeding disorder
• Vertebral body collapse >90% with no remaining cortical shell
• Spinal cord compression requiring decompression surgery

• Fully healed or chronic VCFs without symptoms
• Inability to access pedicle safely (e.g., extreme scoliosis, congenital anomaly)

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Thoracolumbar burst fracture

A technical report highlights the combined treatment of bone metastases using CT imaging and C-arm fluoroscopy to guide microwave thermal ablation and the SpineJack system. The integration of these imaging techniques was crucial for achieving local tumor control and restoring vertebral stability in cases of pathological fractures associated with metastatic disease. CT imaging ensured accurate tumor volume measurement and ablation, safe needle placement, and secure positioning of protective devices. C-arm fluoroscopy provided real-time guidance for the correct positioning of the SpineJack implants, monitoring their expansion, and ensuring controlled cement application. Although these techniques have been increasingly utilized, this is the first detailed report to focus on their combined use in treating pathological fractures within a metastatic setting ¹⁾.

This case-based technical note is a valuable contribution to the growing field of minimally invasive, image-guided oncologic spine interventions. The combination of microwave ablation and the SpineJack system under dual imaging guidance offers a promising approach to managing metastatic vertebral fractures. However, broader validation through prospective studies, inclusion of clinical outcomes, and cost–benefit analyses are needed before widespread adoption.