B and C vertebral fractures types sec. Magherl have univocal indication to the surgery even if are in discussion both type and number of approaches than the characteristics of the osteosynthesis. About A type, instead, is debated if the treatment must be conservative or surgical. With the acquired experience in vertebro/kyphoplasty for the treatment of metastatic osteolytic or ostheoporotic fractures, Verlaan et al, in 2002, emphasized the possibility to use the kyphoplasty, in association to posterior stabilization, for treatment of traumatic toraco-lumbar A1-A2-A3 fractures, in order to reinforce the front column and to increase the vertebral body resistance. This idea, the experience of the kyphoplasty, the sophisticated B-Twin Expandable Spinal System mechanism, initially studied like intersomatic cage, are the base of a our technique for the treatment of great part of A type vertebral fractures.

The expansion of B-twin, introduced with transpe-duncolar approach, raise the plate reducing the fracture and creating an intraspongy space in which is possible to inject the cement at low pressure. We apply this technique approximately from one year, even if still experimental, without any cement complications or vertebral late sinking evidenced although we have always authorized the premature and not protected walking.