Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures - 07/08/14

Doi : 10.1016/j.otsr.2014.06.003

L. Proietti ^a,^⁎ , L. Scaramuzzo ^b , G.R. Schirò ^a , S. Sessa ^a , G. D’Aurizio ^a , F.C. Tamburrelli ^a
^a Department of Orthopedic Science and Traumatology, Spine Surgery Division, Catholic University Rome, Largo A. Gemelli 1, 00168 Roma, Italy
^b Spine Surgery Division 1, IRCCS Istituto Ortopedico Galeazzi Spa, via Riccardo Galeazzi, 4, 20161 Milano, Italy

^⁎Corresponding author. Tel.: +39 06 30 15 43 46; fax: +39 06 51 161.

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Abstract

Background

Treatment of A3 thoraco-lumbar and lumbar spinal fractures nowadays remains a controversial issue. Percutaneous techniques are becoming very popular in the last few years to reduce the approach-related morbidity associated with conventional techniques.

Hypothesis

Purpose of the study was to analyze the clinical and radiological outcome of patients who underwent percutaneous posterior fixation without fusion for the treatment of thoraco-lumbar and lumbar A3 fractures.

Materials and methods

Sixty-three patients, having sustained a single-level thoraco-lumbar fracture, underwent short segment percutaneous instrumentation and were retrospectively analyzed. sagittal index (SI) was calculated in all patients. Clinical and functional outcome were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form General Health Status (SF-36).

Results

Average operative blood loss was 82mL (50–320). Mean pre-operative SI in the thoraco-lumbar segment was 13.3° decreased to 5.8° in the immediate postoperative with a mean deformity correction of 7.5. Mean pre-operative SI in the lumbar segment was 16.5° decreased to 11.3° in the immediate postoperative with a mean deformity correction of 5.2. Not statistically significant correction loss was registered at 1-year minimum follow-up. Constant clinical conditions improvement in the examined patients was observed.