Minimally invasive spine surgeries for treatment of thoracolumbar fractures of spine: A systematic review

Abstract

Purpose: Many minimally invasive surgical (MIS) techniques have been developed for instrumentation of spine. These MIS techniques restore stability, alignment while achieving return to function quite early as compared to open spine surgeries. The main aim of this review was to evaluate role, indications and complications of these MIS techniques in Thoracolumbar and Lumbar fractures. Methods: Pubmed search using key words such as"Percutaneous pedicle screw for Thoracolumbar fractures" and "Video Assisted Thoracoscopy, Thoracoscopic, VATS for thoracolumbar, Lumbar and Spine fractures" were used till July 2016 while doing literature search. Authors analyzed all the articles, which came after search; the articles relevant to the topic were selected and used for the study. Both prospective and retrospective case control studies and randomized control trials (RCT's) were included in this review. Case reports and reviews were excluded. Studies demonstrating use of MIS in cases other than spine trauma and studies with lack of clinical follow up were excluded from this review. Variables such as number of patients, operative time and complications were evaluated in each study. Results: After pubmed search, we found total 68 studies till July 2016 out of which eight studies were relevant for analysis of Video Assisted Thoracoscopy for thoracolumbar and lumbar fractures. Total 72 articles for Percutaneous pedicle screws in thoracolumbar and lumbar fractures were retrieved out of which percutaneous pedicle screws were analyzed in eleven studies and twelve studies involved comparison of percutaneous pedicle screws and conventional open techniques. Conclusion: Role and Indications of the MIS techniques in spinal trauma are expanding quite rapidly. MIS techniques restore stability, alignment while achieving early return to function and lower infection rates as compared to open spine surgeries. In long term, they provide good kyphosis correction and stable fixation and fusion of spine. They are associated with long learning curve and technical challenges but with careful patient selection and in expert hands, MIS techniques may produce better results than open trauma spine surgeries.

Minimally Invasive Versus Open Surgery for the Treatment of Types B and C Thoracolumbar Injuries: A PRISMA Systematic Review

“…8 Growing evidence is demonstrating that minimally invasive spine surgery (MISS) has become as effective as open surgery at treating thoracolumbar spine trauma, with advantages like less soft tissue disruption, lower infection rates, less blood loss, shorter operative time, less postoperative pain, and reduced length of hospitalization. [9][10][11] On the other hand, the high degree of instability associated with these injuries may require fusion to restore stability, which could be impaired in MISS due to suboptimal spine preparation and exposure for proper graft insertion. Also, fracture or dislocation reduction and spine realignment may be difficult to achieve using MISS techniques, especially for type C injuries.…”

“…Also, fracture or dislocation reduction and spine realignment may be difficult to achieve using MISS techniques, especially for type C injuries. 9,10 Considering the sparse literature on this topic, the aims of this systematic review are 2-fold: (1)…”

Comparison of Navigated Expandable Vertebral Cage with Conventional Expandable Vertebral Cage for Minimally Invasive Lumbar/Thoracolumbar Corpectomy

“…If the patient has severe symptoms due to the compression of collapsed vertebra, corpectomy is indicated [ 8 ]. The problem with major surgeries such as corpectomy and long posterior corrective fusion for elderly patients is the high rate of complications [ 9 ]. Currently, minimally invasive (MI) corpectomy is available thanks to spinal surgical technology.…”

Hidden blood loss and its influencing factors after minimally invasive percutaneous transpedicular screw fixation in thoracolumbar fracture

“…The percutaneous approach allows spine surgeons to insert pedicle screws and rods and to connect them percutaneously through small skin incisions. Moreover, this system avoids the disadvantages of conventional surgical treatment, minimizes soft tissue injury, reduces intraoperative blood loss, and results in better postoperative pain scores than other approaches 7,8 . According to past clinical experience, MIPTSF is associated with a relatively low perioperative blood loss because of small incision, reduced muscular dissection, and short operative time 9 .…”