Pure percutaneous pedicle screw fixation without arthrodesis of 32 thoraco-lumbar fractures: clinical and radiological outcome with 36-month follow-up

Cimatti, Marco; Forcato, Stefano; Polli, Filippo Maria; Miscusi, Massimo; Frati, Alessandro; Raco, Antonino

doi:10.1007/s00586-013-3016-x

Cited by 31 publications

(25 citation statements)

References 24 publications

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“…The use of percutaneous fixation is studied on a case-by-case basis. 19,20 Percutaneous fixation can be performed in normal bone or in fragile bone; in the latter case, cemented screws can provide valuable contribution. 12,13 Short-and Middle-Term Results…”

Section: Indications Of Vertebroplasty and Other Vertebral Augmentatimentioning

confidence: 99%

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Bousson

Hamzé

Odri

et al. 2018

Semin intervent Radiol

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Percutaneous vertebral augmentation/consolidation techniques are varied. These are vertebroplasty, kyphoplasty, and several methods with percutaneous introduction of an implant (associated or not with cement injection). They are proposed in painful osteoporotic vertebral fractures and traumatic fractures. The objectives are to consolidate the fracture and, if possible, to restore the height of the vertebral body to reduce vertebral and regional kyphosis. Stabilization of the fracture leads to a reduction in pain and thus restores the spinal support function as quickly as possible, which is particularly important in the elderly. The effectiveness of these interventions on fracture pain was challenged once by two randomized trials comparing vertebroplasty to a sham intervention. Since then, many other randomized studies in support of vertebroplasty efficacy have been published. International recommendations reserve vertebroplasty for medical treatment failures on pain, but earlier positioning may be debatable if the objective is to limit kyphotic deformity or even reexpand the vertebral body. Recent data suggest that in osteoporotic fracture, the degree of kyphosis reduction achieved by kyphoplasty and percutaneous implant techniques, compared with vertebroplasty, is not sufficient to justify the additional cost and the use of a somewhat longer and traumatic procedure. In young patients with acute traumatic fractures and a significant kyphotic angle, kyphoplasty and percutaneous implant techniques are preferred to vertebroplasty, as in these cases a deformity reduction has a significant positive impact on the clinical outcome.

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Section: Indications Of Vertebroplasty and Other Vertebral Augmentatimentioning

confidence: 99%

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Bousson

Hamzé

Odri

et al. 2018

Semin intervent Radiol

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“…The average score achieved in the SF-36 psychological score was 56.22, which exceeds the scores from the back pain population (48.25) and the normal population (51.54). 17 In the study of Schmidt et al, of the 76 patients with type A fractures who were treated with minimally invasive instrumentation, 32 patients (42.1%) had no substantial discomfort and pain as compared before surgery. Six months following surgery, 58 patients (76.3%) met their expectations or were highly pleased by their individual postoperative results.…”

Section: Discussionmentioning

confidence: 98%

Less Invasive Surgery is Feasible in the Management of Traumatic Thoracolumbar Fractures in Isolated and Polytrauma Injury

et al. 2019

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Background: Less invasive stabilization systems (LISSs) have gained popularity. However, limited quality of life (QOL) and clinical outcome data exist for trauma patients treated with LISSs. The objective of this study is to describe QOL and outcome for posterior percutaneous pedicle screw fixation in the management of traumatic thoracolumbar fractures. Methods: Between January 2006 and December 2011, data from all patients treated with a posterior percutaneous pedicle screw fixation technique for thoracolumbar fractures were collected and analyzed. Sixty-nine patients met the inclusion criteria. Additional vertebral reduction and cement augmentation was used in 25 patients, when there was more than 50% of vertebral body comminution. Results: Mean follow up of 19 months (range ¼ 6-49 months). Fifty-one percent of the study population consisted of polytrauma patients, with 22% having injury severity score ! 15. In 6 cases (8.7%) there were perioperative complications. Response rate for the follow-up health survey was 78%, with a satisfactory overall median EuroQuol score of 0.811 (Q1-Q3 95% confidence interval ¼ 0.709-0.897). Conclusions: Posterior percutaneous pedicle screw fixation proves to be effective in the management of traumatic thoracolumbar fractures, with a good overall functional outcome. Percutaneous techniques that reduce perioperative morbidity are an alternative approach well suited for damage control orthopaedics, as long as there are no neurological deficits. Especially in polytrauma patients with spine fractures, the spinal column can be stabilized in an emergency setting, while limiting the risks of ''a second hit'' at the patients' already frail condition. Level of Evidence: 3.

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“…The fixation of burst fractures by posterior approach is generally conducted with posterolateral fusion or posterior fusion. However, other authors 8,10,26,30,33,35,36) reported good results by using open or percutaneous pedicle screw fixation only without fusion.…”

Section: Introductionmentioning

confidence: 99%

“…There are only few literatures available which describes percutaneous screw fixation for thoracolumbar burst fracture 8,26,35,36) . Spinal canal integrity, sagittal balance and anterior column intactness are very important for successful outcome in this type of injury.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures

Kim

Paudel

Kim

et al. 2017

J Minim Invasive Spine Surg Tech

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Objective: The optimal treatment methods for thoracolumbar burst fracture with intact neurology are not established yet. Spinal canal integrity, sagittal balance and anterior column intactness are very important for successful outcome in this type of injury. There is no study analyzing restoration of these parameters by low pressure restoration using postural pillow reduction and lordotic posterior column compressive percutaneous transpedicular screw fixation and this study analyzes canal remodeling, spinal balance and anterior column intactness after this procedure. Methods: The surgical procedure included three different elements: (1) preoperative postural pillow reduction for 1-2 days, (2) augmentation of fractured vertebra by polymethylmethacrylate (PMMA) in osteoporotic bone or by non-PMMA materials in non-osteoporotic bone, and (3) lordotic, posterior column compressive, percutaneous transpedicular screw fixation. We measured anterior vertebral height, canal size and lordotic angle preoperatively, immediate postoperatively and after 6 months in 34 patients treated with this technique and were analyzed. Results: Of 34 patients 17 were male. The mean age was 52.03±12.51 years. They were followed for 30.68±11.67 months on average. At 6 months, preoperative canal stenosis of 44% remodeled to 12%, preoperative anterior vertebral height of 44% increased to 77% and preoperative average kyphosis of 14 degrees corrected to 3.4 degrees No neurological deterioration noted. Functionally all patients returned to their previous status. Conclusion: The postural pillow reduction and lordotic posterior column compressive percutaneous screw fixation in patients with neurologically intact thoracolumbar burst fracture is effective and safe.

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Pure percutaneous pedicle screw fixation without arthrodesis of 32 thoraco-lumbar fractures: clinical and radiological outcome with 36-month follow-up

Cited by 31 publications

References 24 publications

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Less Invasive Surgery is Feasible in the Management of Traumatic Thoracolumbar Fractures in Isolated and Polytrauma Injury

Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures

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