PDF herunterladen
CC BY 4.0 · Surg J (N Y) 2016; 02(04): e131-e138
DOI: 10.1055/s-0036-1594248
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series

Nitin Agarwal
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
,
Phillip A. Choi
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
,
Raymond F. Sekula
1   Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
› Institutsangaben
Weitere Informationen

Publikationsverlauf

04. Juli 2016

19. Oktober 2016

Publikationsdatum:
17. November 2016 (online)

Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation.

Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course.

Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure.

Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.

Keywords

thoracolumbar burst fracture - minimally invasive spine surgery - fusion - spine trauma
 

  • References

  • 1 Bensch FV, Koivikko MP, Kiuru MJ, Koskinen SK. The incidence and distribution of burst fractures. Emerg Radiol 2006; 12 (03) 124-129
    CrossrefPubMedGoogle Scholar
  • 2 Blondel B, Fuentes S, Pech-Gourg G, Adetchessi T, Tropiano P, Dufour H. Percutaneous management of thoracolumbar burst fractures: evolution of techniques and strategy. Orthop Traumatol Surg Res 2011; 97 (05) 527-532
    CrossrefPubMedGoogle Scholar
  • 3 Korovessis P, Hadjipavlou A, Repantis T. Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures. Spine 2008; 33 (06) 658-667
    CrossrefPubMedGoogle Scholar
  • 4 Yang WE, Ng ZX, Koh KM. , et al. Percutaneous pedicle screw fixation for thoracolumbar burst fracture: a Singapore experience. Singapore Med J 2012; 53 (09) 577-581
    PubMedGoogle Scholar
  • 5 Ni W-F, Huang Y-X, Chi Y-L. , et al. Percutaneous pedicle screw fixation for neurologic intact thoracolumbar burst fractures. J Spinal Disord Tech 2010; 23 (08) 530-537
    CrossrefPubMedGoogle Scholar
  • 6 Palmisani M, Gasbarrini A, Brodano GB. , et al. Minimally invasive percutaneous fixation in the treatment of thoracic and lumbar spine fractures. Eur Spine J 2009; 18 (Suppl. 01) 71-74
    CrossrefPubMedGoogle Scholar
  • 7 Wild MH, Glees M, Plieschnegger C, Wenda K. Five-year follow-up examination after purely minimally invasive posterior stabilization of thoracolumbar fractures: a comparison of minimally invasive percutaneously and conventionally open treated patients. Arch Orthop Trauma Surg 2007; 127 (05) 335-343
    CrossrefPubMedGoogle Scholar
  • 8 Rampersaud YR, Annand N, Dekutoski MB. Use of minimally invasive surgical techniques in the management of thoracolumbar trauma: current concepts. Spine 2006; 31 (11, Suppl): S96-S102 , discussion S104
    CrossrefPubMedGoogle Scholar
  • 9 Smith WD, Dakwar E, Le TV, Christian G, Serrano S, Uribe JS. Minimally invasive surgery for traumatic spinal pathologies: a mini-open, lateral approach in the thoracic and lumbar spine. Spine 2010; 35 (26, Suppl): S338-S346
    CrossrefPubMedGoogle Scholar
  • 10 Alpantaki K, Bano A, Pasku D. , et al. Thoracolumbar burst fractures: a systematic review of management. Orthopedics 2010; 33 (06) 422-429
    CrossrefPubMedGoogle Scholar
  • 11 Dhall SS, Wadhwa R, Wang MY, Tien-Smith A, Mummaneni PV. Traumatic thoracolumbar spinal injury: an algorithm for minimally invasive surgical management. Neurosurg Focus 2014; 37 (01) E9
    PubMedGoogle Scholar
  • 12 Shen W-J, Liu T-J, Shen Y-S. Nonoperative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurologic deficit. Spine 2001; 26 (09) 1038-1045
    Google Scholar
  • 13 Fuentes S, Blondel B, Metellus P, Gaudart J, Adetchessi T, Dufour H. Percutaneous kyphoplasty and pedicle screw fixation for the management of thoraco-lumbar burst fractures. Eur Spine J 2010; 19 (08) 1281-1287
    CrossrefPubMedGoogle Scholar
  • 14 Dai LY, Jiang LS, Jiang SD. Posterior short-segment fixation with or without fusion for thoracolumbar burst fractures. a five to seven-year prospective randomized study. J Bone Joint Surg Am 2009; 91 (05) 1033-1041
    PubMedGoogle Scholar
  • 15 Hübschle L, Borgström F, Olafsson G. , et al; SWISSspine Registry Group. Real-life results of balloon kyphoplasty for vertebral compression fractures from the SWISSspine registry. Spine J 2014; 14 (09) 2063-2077
    CrossrefPubMedGoogle Scholar
  • 16 Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 2007; 16 (08) 1085-1100
    CrossrefPubMedGoogle Scholar
  • 17 Bouza C, López T, Magro A, Navalpotro L, Amate JM. Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review. Eur Spine J 2006; 15 (07) 1050-1067
    CrossrefPubMedGoogle Scholar
  • 18 Hulme PA, Krebs J, Ferguson SJ, Berlemann U. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 2006; 31 (17) 1983-2001
    CrossrefPubMedGoogle Scholar
  • 19 Lee MJ, Dumonski M, Cahill P, Stanley T, Park D, Singh K. Percutaneous treatment of vertebral compression fractures: a meta-analysis of complications. Spine 2009; 34 (11) 1228-1232
    CrossrefPubMedGoogle Scholar
  • 20 Taylor RS, Taylor RJ, Fritzell P. Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine 2006; 31 (23) 2747-2755
    CrossrefPubMedGoogle Scholar
  • 21 Eck JC, Nachtigall D, Humphreys SC, Hodges SD. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 2008; 8 (03) 488-497
    CrossrefPubMedGoogle Scholar
  • 22 Albert HB, Godskesen M, Westergaard JG. Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine 2002; 27 (24) 2831-2834
    CrossrefPubMedGoogle Scholar
  • 23 Carl AL, Tromanhauser SG, Roger DJ. Pedicle screw instrumentation for thoracolumbar burst fractures and fracture-dislocations. Spine 1992; 17 (8, Suppl): S317-S324
    CrossrefPubMedGoogle Scholar
  • 24 Alanay A, Acaroglu E, Yazici M, Oznur A, Surat A. Short-segment pedicle instrumentation of thoracolumbar burst fractures: does transpedicular intracorporeal grafting prevent early failure?. Spine 2001; 26 (02) 213-217
    CrossrefPubMedGoogle Scholar