A Clinical Study to Collect Real-wordt Data on Safety and Clinical Performance of the VCFix Spinal System for Treatment of Vertebral Compression Fractures of (Suspected) Osteoporotic Origin. (EXPAND-US)

Adult patients undergoing treatment with the VCFix Spinal System as part of standard clinical care for vertebral compression fractures. The study will enroll patients treated according to routine clinical practice and will collect real-world evidence on clinical outcomes, radiographic outcomes, and patient-reported outcomes following treatment.

Inclusion Criteria:

• 1. Subject is ≥ 21 to ≤ 85 years old. 2.

Single vertebral fracture which meets all of the following criteria:

• Type A fractures from AO spine classification (compression injuries);
• Vertebral fracture located in the thoracic and lumbar regions of the spine
• Fracture age < 6 weeks or fractures with anatomic signs of reducibility (based on radiographic evidence as well as patient history)
• Vertebral fracture shows an estimated height loss in the anterior or mid third of the vertebral body (VB) of at least 10% but not more than 60% based on radiographic evidence
• Target VB has appropriate anatomy, i.e. suitable pedicle diameter, pedicle length and chord length that would allow for selection of correct implant size, as described in the IFU and based on axial MRI/CT scan before surgery 3. Subject is diagnosed with, or has a suspected diagnosis of, severe osteoporosis, including low trabecular bone quality , and/or an oversized vertebral body as compared to implant size (e.g. relatively small pedicle requiring smaller implant size than desired for vertebral body size and/or fracture characteristics and location) 4. Subject has a NPRS back pain score of ≥5 5. Subject is a candidate for surgical intervention based on investigator opinion 6. Subject has a body Mass Index (BMI) < 35 7. Subject is mentally capable of complying with trial protocol requirements for the duration of the study 8. Subject can understand the risks and benefits of participating in the study and is able to provide written informed consent

Exclusion Criteria:

1. Neoplasms with posterior involvement and/or presence of a mass within the spinal canal

2. Non-mobile fractures (i.e., fracture is not recent (>6 weeks), bone marrow edema or fluid or empty cleft are not visible in radiographic imaging, or fracture mode does not allow for fracture reduction in craniocaudal direction).

3. Spondylolisthesis > Grade 1 at target vertebral body(s)

4. Local kyphotic angle > 30°

5. Any pre-existing vertebral fracture prior to the index fracture

6. Previous spine surgery, balloon kyphoplasty or vertebroplasty, for any vertebral fracture

7. Subjects that require anterior stabilization of the index fracture

8. Fracture to the pedicle based on radiographic evaluation

9. Spinal cord compression or canal compromise requiring decompression

10. Severe back pain due to causes other than acute fracture with NPRS score > 5

11. The subject has pain based on clinical diagnosis of herniated nucleus pulposus or severe spinal stenosis (progressive weakness or paralysis)

12. Pain due to any other condition that requires daily narcotic (opiates or opioids) medication

13. Pre-existing neurological deficit, radiculopathy or myelopathy

14. Pre-existing condition or significant co-morbidity:

    1. Uncontrolled diabetes (HbA1c >8%)
    2. Severe cardiopulmonary deficiencies
    3. Any other condition that would impact study outcome in the opinion of the investigator

15. Irreversible coagulopathy or bleeding disorder

16. Contraindications to both MRI and Computed Tomography (CT) imaging

17. Concurrent participation in another clinical study which could potentially interfere with the outcome of this study

18. A life expectancy less than the study duration or undergoing palliative care

19. Subject non-ambulatory prior to fracture Allergy to any components of the device/instruments used during the procedure

20. Allergy to any components of the device/instruments used during the procedure

21. Active or incompletely treated infection of the vertebral column or active systemic infection, including unresolved urinary tract infection

22. Any underlying systemic bone disease other than osteoporosis (e.g., osteomalacia, osteogenesis imperfecta, Paget's disease, etc.)

23. Any evidence of alcohol or drug abuse

24. Ongoing long-term steroid therapy (steroid dose ≥30 mg /day for >3 months)

25. The subject is currently on anti-cancer therapy or anti-HIV therapy

26. Pregnancy or subjects with child-bearing potential that are unwilling to use contraception throughout the study duration.

27. Patient known to be involved in medical litigation including Workmen's Compensation prior to the surgery