Correct positioning of pedicle screws with a percutaneous minimal invasive system in spine trauma - 29/04/14

Doi : 10.1016/j.otsr.2014.03.015

M. Tinelli ^a, S. Matschke ^a, M. Adams ^a, P.A. Grützner ^a, M. Münzberg ^a, A.J. Suda ^a,^⁎,^b
^a Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany
^b Department for Septic Surgery, BG Trauma Center Ludwigshafen, Germany

^⁎Corresponding author. Tel.: +49 621 68100; fax: +49 621 6810 2685.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 29 April 2014
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Abstract

Background

When performing minimally invasive spine surgery in trauma patients, a short operation time and a perfect positioning of pedicle screws are demanded. In this study, we show that a Minimally Invasive Pedicle Screw System allows both.

Methods

One hundred and twenty-one patients (131 fractures) with fractures between Th 3 and L 5 were treated. The most common fracture type was A3. We treated 52 females and 69 men with a mean age of 56.7 years. In 72% of the cases, the procedure was performed by two experienced spine surgeons. Postoperatively, all patients were examined using a CT-scan. In 61 patients, an anterior stabilization was additionally performed in 33 patients, vertebroplasty or cyphoplasty was performed. Fifteen patients underwent laminectomy.

Results

No patient postoperatively developed any additional neurological compromise. In total, 682 screws were placed. In the postoperative CT-scan, we found 16 screws (2.2%) in suboptimal position, 8 with medial and 8 with lateral deviation.

Discussion

With the Minimally Invasive Pedicle Screw System used in this study, spinal fractures can be treated in a short operation time with percutaneous stabilization and a correct positioning of the pedicle screws in almost 98%. In our study, no screw was so much malpositioned that revision surgery would have been necessary.