Percutaneous Fixation of Thoracolumbar Vertebral Fractures

Overview

Journal EFORT Open Rev

Specialty Orthopedics

Date 2019 Jan 1

PMID 30595846

Citations 5

Authors

Amer Sebaaly

Maroun Rizkallah

Guillaume Riouallon

Zhi Wang

Pierre Emmanuel Moreau

Falah Bachour

Ghassan Maalouf

Affiliations

Soon will be listed here.

Abstract

Surgical treatment of patients with thoracolumbar vertebral fracture without neurological deficit is still controversial.Management of vertebral fracture with percutaneous fixation was first reported in 2004.Advantages of percutaneous fixation are: less tissue dissection; decreased post-operative pain; decreased bleeding and operative time (depending on the steep learning curve); better screw positioning with fluoroscopy compared with an open freehand technique; and a decreased infection rate.The limitations of percutaneous fixation of vertebral fractures include increased radiation exposure to the patient and the surgeon, together with the steep learning curve for this technique.Adding a screw at the level of the fractured vertebra has the advantages of incorporating fewer motion segments with less operative time and bleeding. This also increases the axial, sagittal and torsional stiffness of the construct.Percutaneous fixation alone without grafting is sufficient for treating type A and B1 (AO classification) thoracolumbar fractures with satisfactory results concerning kyphosis reduction when compared with open instrumentation and fusion and with open fixation.Type C and B2 fractures (ligamentous injuries) should undergo fusion since the ligamentous healing is mechanically weak, increasing the risk of instability.This review offers a detailed description of percutaneous screw insertion and discusses the advantages and disadvantages. Cite this article: 2018;3:604-613. DOI: 10.1302/2058-5241.3.170026.

Citing Articles

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Surgical management of thoracolumbar junction fractures: An evidence-based algorithm.

Lucifero A, Bruno N, Luzzi S World Neurosurg X. 2023; 17:100151.

PMID: 36793355 PMC: 9923224. DOI: 10.1016/j.wnsx.2022.100151.

Risk Factors for Postoperative Loss of Correction in Thoracolumbar Injuries Caused by High-Energy Trauma Treated via Percutaneous Posterior Stabilization without Bone Fusion.

Hirota R, Teramoto A, Irifune H, Yoshimoto M, Takahashi N, Chiba M Medicina (Kaunas). 2022; 58(5).

PMID: 35630000 PMC: 9146628. DOI: 10.3390/medicina58050583.

The Radiological Complications of Short-Segment Pedicle Screw Fixation Combined with Transforaminal Interbody Fusion in the Treatment of Unstable Thoracolumbar Burst Fracture: A Retrospective Case Series Study in Vietnam.

Nguyen N, Phan T Orthop Res Rev. 2022; 14:91-99.

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Posterior Ligamentous Complex Injuries of the Thoracolumbar Spine: Importance and Surgical Implications.

Bizdikian A, Rachkidi R Cureus. 2021; 13(10):e18774.

PMID: 34796064 PMC: 8590454. DOI: 10.7759/cureus.18774.

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