Posterior percutaneous spine instrumentation

Lowery, Gary L.; Kulkarni, Samir S.

doi:10.1007/pl00008318

Cited by 94 publications

(64 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The rod connectors were just under the fascia with this system. The results were satisfactory with a 61% fusion rate in 8 months [9]. One year later, a novel instrument (sextant) was presented by Foley KT and Gupta SK.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Minimally Invasive Stabilization for Thoracolumbar Fractures

SarÄ±kafa¹,

Demirkol²,

Peker³

et al. 2013

J Spine

View full text Add to dashboard Cite

Minimally invasive approaches are becoming increasingly widespread due to numerous potential advantages (smaller scars, diminished local pain, reduced blood loss, reduced postoperative wound pain, shorter hospital stays) in spinal surgery. Nowadays, minimally invasive stabilization is more frequently used to treat some thoracolumbar fractures. The aim of this study is to explore the feasibility and effect of minimally invasive stabilization for the treatment of unstable thoracolumbar fractures without neurological impairment. From October 2011 to February 2012, 20 patients with thoracolumbar fracture who were treated with minimally invasive stabilization were included in this study. Charts and operative notes were analyzed for epidemiological data, injured segments, operative time, bleeding volume, mobilization interval, complications and lengths of stay. All patients were successfully managed with minimally invasive stabilization. There were 14 males and 6 females with a mean age of 33.75 years ranging from 18 to 59 years. The L1 vertebra was the most injured vertebral level (35%), followed by T12 and L2. Mechanisms of injury included falling from a height (12 patients) and traffic accidents (8 patients). The average operative time was 72 minutes (range 60 to 122 min). The average intraoperative blood loss was 80 ml (range 50 to 270 ml). Minimally invasive instrumentation of the spine reduces intraoperative blood loss, soft tissue trauma, operative time, infection rates and hospital stay. Future developments in minimally invasive technology will lead to improved results with increased indications and applications.

show abstract

Section: Discussionmentioning

confidence: 94%

“…They also showed significant improvisation of the percutaneous system [8]. In 2000, Lowery and Kulkarini [9] described a more contemporary system. In their approach, insertion of the anterior interbody graft via laparoscopy was primarily performed, and the posterior percutaneous pedicle screws with rod connectors were then placed.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Stabilization for Thoracolumbar Fractures

SarÄ±kafa¹,

Demirkol²,

Peker³

et al. 2013

J Spine

View full text Add to dashboard Cite

show abstract

“…As proposed already in lumbar spine surgery, this might reduce the denervation of muscles and hospital stay [10,16,21,22,38,44] and reduces the increased complication rate following posterior or combined anterior-posterior approaches [37]. The disadvantage of the technique clearly resulted from stabilization-only character, which limits the indications.…”

Section: Discussionmentioning

confidence: 98%

“…These posterior instrumentation procedures have been shown to be associated with increased postoperative complications [37,43]. Similar to stabilization procedures of the thoracolumbar spine, which have been proposed to reduce access-related morbidity as muscular denervation, atrophy, length of hospital stay, blood loss and postoperative pain [16,21,22], minimally invasive procedures for posterior cervical instrumentation represent the next logical step. Therefore, several authors reported minimally invasive posterior procedures for stabilization and decompression of the cervical spine [5,8,33,40,45]; however, the long-term benefit on clinical outcome remains to be proven.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, multi-level posterior as well as combined anteriorposterior approaches to the cervical spine are proposed to be associated with increased incidence of perioperative complications [37]. Similar to stabilization procedures of the thoracolumbar spine with the objective to reduce access-related morbidity as muscular denervation and atrophy, length of hospital stay and blood loss [10,16,21,22,38,44], minimally invasive procedures for cervical instrumentation represent the next step to reduce accessrelated muscular trauma. Therefore, several authors reported minimally invasive posterior procedures for stabilization and decompression of the cervical spine [8,33,40,45].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous instrumentation of the cervical and cervico-thoracic spine using pedicle screws: preliminary clinical results and analysis of accuracy

et al. 2011

View full text Add to dashboard Cite

The pedicle screw instrumentation represents the most rigid construct of the cervical and cervicothoracic spine and in spite of the risks to neurovascular structures clinical relevant complications do not occur frequently. The steep angles of the cervical pedicles result in a wide surgical exposure with extensive muscular trauma. The objective of this study was the evaluation of the accuracy of cervical pedicle screw insertion through a minimally invasive technique to reduce access-related muscular trauma. Therefore, percutaneous transpedicular instrumentation of the cervical and cervicothoracic spine was performed in 15 patients using fluoroscopy. All instrumentations from C2 to Th4 were inserted bilaterally through 2 to 3-cm skin and fascia incisions even in multilevel procedures and the rods were placed by blunt insertion through the incision. Thin-cut CT scan was used postoperatively to analyze pedicle violations. 76.4% of 72 screws were placed accurately. Most pedicle perforations were seen laterally towards the vertebral artery. Critical breaches [2 mm or narrowing of the transversal foramen occurred in 12.5% of screws; however, no revision surgery for screw displacement was needed in the absence of clinical symptoms. No conversion from percutaneous to open surgery was necessary. It was concluded that percutaneous transpedicular instrumentation of the cervical spine is a surgically demanding technique and should be reserved for experienced spine surgeons. The indications are limited to instrumentation-only procedures or in combination with anterior treatment, but with the potential to minimize access-related morbidity.

show abstract