Minimally invasive spine surgery in the treatment of thoracolumbar and lumbar spine trauma

Abstract

<jats:p>Thoracolumbar and lumbar trauma account for the majority of traumatic spinal injuries. The mainstay of current treatments is still nonoperative therapy with bracing. Classic treatment algorithms reserved absolute surgical intervention for spinal trauma patients with neurological compromise or instability. Relative indications included incapacitating pain and obesity/body habitus making brace therapy ineffective. In the past decade, minimally invasive surgical (MIS) techniques for spine surgery have been increasingly used for degenerative conditions. These same minimally invasive techniques have seen increased use in trauma patients. The goal of minimally invasive surgery is to decrease surgical morbidity through decreased soft-tissue dissection while providing the same structural stability afforded by classic open techniques. These minimally invasive techniques involve percutaneous posterior pedicle fixation, vertebral body augmentation, and utilization of endoscopic and thoracoscopic techniques. While MIS techniques are somewhat in their infancy, an increasing number of studies are reporting good clinical and radiographic outcomes with these MIS techniques. However, the literature is still lacking high-quality evidence comparing these newer techniques to classic open treatments. This article reviews the relevant literature regarding minimally invasive spine surgery in the treatment of thoracolumbar and lumbar trauma.</jats:p>

MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics

“…Distribution of evidence quality (levels of evidence [13]) of the lateral-approach specific articles included 27 Level 1 Eur Spine J studies (of which 26 were non-clinical), 3 Level 2 studies, 30 Level 3 studies, 155 Level 4 studies, and 22 Level 5 studies. Of these 237 articles, 22 were MI-LIF-specific studies of lateral anatomy relevant to the surgical approach , 17 were biomechanical or non-interventional testing studies [37-53], 11 technical descriptions [2,9,10,[54][55][56][57][58][59][60][61], 40 case reports [62-101], 30 reports specifically examining complications , 43 studies assess clinical and/or radiographic outcomes in degenerative conditions , 23 specifically examining treatment and outcomes of deformity with MI-LIF , 10 articles reviewing traumatic or thoracic indications [218][219][220][221][222][223][224][225][226][227], and 41 review articles without original data [198][199][200][201][202][203][204][205][206][207][208][209][210][211][212][213][214][215][216][217].…”

Analysis of results of reduction of kiphotic deformation by minimally invasive transpedicular stabilization in patients with traumatic compression fractures of thoracolumbar localization

“…При таком характере переломов основным риском является миграция отломков костей и развитие посттравматической кифотической деформации позвоночника [1-3, 11, 16, 21]. В этом случае нарушается распределение статических и динамических нагрузок на передние отделы позвонков, что способствует смещению межпозвоночного диска и фрагментов костей в позвоночный канал, вызывая неврологические симптомы за счёт компрессии спинного мозга, спинномозговых корешков, а также вторичных ликворо-гемодинамических нарушений вследствие сдавления дурального мешка и венозного сплетения позвоночного канала [3,16,22].…”

Outcomes of percutaneous pedicle screw fixation for spinal trauma and tumours

“…With minimal keyhole incisions, the surrounding tissue is largely spared [1,2,5], therefore, reducing blood loss and allowing faster recovery and mobilisation [1,4]. Although MIS techniques have been shown to be useful in the treatment of thoracolumbar injury, the current literature has failed to demonstrate a reduction in morbidity [6].…”