Percutaneous Pedicle Screw Fixation for Neurologic Intact Thoracolumbar Burst Fractures

Ni, Wenfei; Huang, Yixing; Chi, Yong-Long; Xu, Huazi; Lin, Yan; Wang, Xiangyang; Huang, Qi-Shan; Mao, Fang-Min

doi:10.1097/bsd.0b013e3181c72d4c

Cited by 141 publications

(108 citation statements)

References 22 publications

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“…[58][59][60] The minimally invasive technique with percutaneous screws without fusion in patients with compression fractures offer better results with less postoperative pain but longer surgical time, and no differences in rehabilitation. 58,60 Compared with open procedures, minimally invasive spine surgery allows to be addressed through smaller incisions with less soft-tissue damage and postoperative pain, which may lead to shorter hospitalizations and earlier mobility for the patient. 61 MISS techniques may be an excellent solution in the politrauma patients, providing ''damage-control spinal stabilization.''…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

“…These new techniques require a steep learning curve and to be able to dominate them we must first dominate open surgery. 58 Whenever possible, the thoracoscopic approach of fractures offers significant advantages, mainly seen in lower pain postoperatively, aesthetic results, less morbidity and quicker return to daily activities. Reports show less time with pain medication in 31% compared to open 42%.…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Management of burst fractures in the thoracolumbar spine

Cahueque

Cobar

Zúñiga³

et al. 2016

Journal of Orthopaedics

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Section: Minimally Invasive Surgerymentioning

confidence: 99%

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Management of burst fractures in the thoracolumbar spine

Cahueque

Cobar

Zúñiga³

et al. 2016

Journal of Orthopaedics

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“…1,17,19,22 The main advantage of percutaneous pedicle screws is reduction of soft tissue dissection and muscle damage, intraoperative blood loss, operative time, and requirement for postoperative analgesics. 12,17,19,22 Percutaneous methods do not allow for direct decompression of neural elements; however they may allow for decompression of neural elements using ligamentotaxis via distraction maneuvers on the percutaneous screws. Prior reports of percutaneous pedicle screw fixation for the treatment of flexion-distraction injuries show promising results; however, they are primarily limited to bony Chance fractures.…”

Section: 1322mentioning

confidence: 99%

Flexion-distraction injuries of the thoracolumbar spine: open fusion versus percutaneous pedicle screw fixation

Grossbach¹,

Dahdaleh

Abel³

et al. 2013

FOC

104

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Object Flexion-distraction injuries occur due to distractive forces causing disruption of the posterior and middle spinal columns. These fractures classically consist of a fracture line through the posterior bony elements; involvement of the posterior ligamentous complex is, however, common. Surgical treatment is often required for these unstable injuries to avoid neurological deterioration and posttraumatic kyphosis, and the surgery traditionally consists of an open posterior approach with instrumented fusion. Percutaneous pedicle screw fixation for these injuries, with the goal of minimal tissue disruption and preservation of normal anatomy while achieving adequate stabilization, has recently been reported in the literature, but to date, a direct comparative study comparing open and percutaneous fixation has not been reported. The authors report their experience treating these fractures with both techniques and review the available literature. Methods Patients with flexion-distraction injury who were treated between May 2003 and March 2013 were prospectively followed. American Spinal Injury Association scores and degree of kyphotic angulation were recorded at admission, discharge, and follow-up. Data regarding intraoperative blood loss and operative time were obtained from a chart review. Patients treated with open versus minimally invasive procedures were compared. Results The authors identified 39 patients who suffered flexion-distraction injuries and were treated at their institution during the specified period; one of these patients declined surgery. All had injury to the posterior ligamentous complex. Open surgical procedures with pedicle screw fixation and posterolateral fusion were performed in 27 patients, while 11 patients underwent minimally invasive pedicle screw placement. Overall, there was improvement in kyphotic angulation at the time of discharge as well as most recent follow-up in both the open surgery and minimally invasive surgery (MIS) groups. The authors found no significant difference in American Spinal Injury Association score or the degree of kyphotic angulation between the MIS and open surgery groups. There was a trend toward shorter operative time for the MIS group, and patients who underwent minimally invasive procedures had significantly less blood loss. Conclusions Minimally invasive percutaneous pedicle screw fixation appears to have similar efficacy in the treatment of flexion-distraction injuries and it allows for reduced blood loss and tissue damage compared with open surgical techniques. Therefore it should be considered as an option for the treatment of this type of injury.

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“…Operative treatment usually involves instrumented intervertebral fusion, with or without spinal decompression. The three major surgical approaches for stabilization are posterior, anterior, or combined AP [26,35,37,40,49,53].…”

mentioning

confidence: 99%