Minimally invasive spine (MIS) surgery in traumatic thoracolumbar fractures: A single-center experience

Abstract

Objective: Traumatic thoracolumbar fractures are common, and surgical fixation is a well-established treatment option, with the aim to achieve spinal stability and preserve neurological function. Pedicle screw fixation using a minimally invasive spine (MIS) surgical approach has emerged as an alternative approach for the treatment of thoracolumbar fractures. The aim of this study is to collect data regarding epidemiology, management, and outcomes of patients treated with MIS pedicle screw fixation for traumatic thoracolumbar fractures in our neurosurgical department. Materials and Methods: This was a retrospective cohort study including all patients who underwent MIS fixation from March 2013 to March 2017. Results: A total of 125 patients were included, 61 males and 64 females; the mean age was 59 years. The majority of injuries were from falls. In 48 cases, the fracture involved a thoracic vertebra and in 77 cases a lumbar vertebra. More than 10% of the patients presented with a neurological deficit on admission and 75% of those showed postoperative improvement in their neurology. The average length of hospital stay was 14 days. MIS fixation achieved a satisfactory regional sagittal angle (RSA) postoperatively in all patients. The vast majority of patients had no or mild postoperative pain and achieved a good functional outcome. Conclusions: MIS fixation is a safe surgical option with comparable outcomes to open surgery and a potential reduction in perioperative morbidity. MIS surgery achieves a rapid and significant improvement in pain score, functional outcome, Frankel Grade, and RSA. We expect that MIS fixation will become the predominant technique in the management of traumatic thoracolumbar fractures.

Use of Minimally Invasive Spine Surgery in the Management of High-grade Thoracolumbar Spine Injuries

“…At a follow-up period of 2 years post-operatively, patients had no pain or mild pain with VAS scores between 0 and 3. Such results correspond with our data of 12.5 days and 2.6 for average length of stay and back pain VAS at 20 month follow-up [21].…”

“…Average blood loss was reported to be 240 mL, average length of stay slightly less than 1 week, and VAS score for back pain at 1-year follow-up was 1.4 ± 0.9 [ 20]. Regarding percutaneous pedicle screw fixation, Ansar et al [21] used this technique in 125 patients with high-grade thoracolumbar traumas. Patients selected for the study had either three-column injuries or new neurological deficits on presentation.…”

Short-Segment Pedicle Fixation of Traumatic Low Lumbar Fractures (L3–L5)

“…Controversy still exists about whether short-segment pedicle screw instrumentation is a suitable method for unstable lumbar burst fracture. 21 In 2020, Ansar et al 22 published results from Royal Preston Hospital from 2013 to 2017 including 125 patients with 13 in the low lumbar region, investigating minimally invasive pedicle screw fixation similarly using fluoroscopic imaging to guide percutaneous placement of pedicle screws. The procedure was categorized into 3 categories: 1 level above and below the fracture, 2 levels above and below the fracture, and short pedicle screws at fracture level in addition to one level above and below.…”

Effect of postural nursing intervention on preventing pressure injury after thoracolumbar incision and internal fixation in southern China

“…Thoracolumbar fractures are more common in the clinic, these patients have high risk and severe symptoms, and need to stay in bed for a long time after the completion of surgical treatment (Ansar et al, 2020;Spiegl et al, 2019). Most patients are prone to complications after surgery, which affects their recovery.…”