Early results of percutaneous plate fixation of unstable fractures of the dorsolumbar spine

ABSTRACT

Standard techniques for lumbar pedicle screw fixation involve open exposures and extensive muscle dissection that is associated with extensive blood loss, lengthy hospital stays, and significant cost. Mini-invasive techniques are widely accepted as being the less aggressive procedure in any kind of surgery. Further attempts of development of percutaneous techniques in spinal surgery were reported, but little among them with a real success. The aim of the present study is to evaluate the early results of treatment of unstable fractures of the dorsolumbar spine using the WSH [world spine holding] percutaneous spine fixation system. From March 2005 to March 2006, fourteen patients aged 18 - 58 years with unstable fractures of the dorsolumbar spine without neurological impairment were treated in Mansoura Emergency Hospital with the WSH percutaneous spine fixation system. The range of follow-up of the patients was 6-18 months. The mean operative time was around one hour and blood loss was negligible. The mean hospital stay was two days. According to the modified Macnab criteria, excellent results are 78.6%, good results are 14.3% and fair results are 7.1%. Complications included only one patient with subcutaneous hematoma and the need for screw reposition in one case. No septic problem was encountered. We conclude that preliminary results of the percutaneous fixation of the dorsolumbar fracture were promising allowing the surgeon to perform biomechanically sound internal spinal fixation with minimal tissue trauma to minimize approach related morbidity while achieving the same result as more traditional, invasive approaches