Percutaneous pedicle screw fixation for traumatic thoracolumbar fracture without neurologic deficits / 中华创伤杂志

ABSTRACT

Objective To evaluate the feasibility and safety of percutaneous posterior pedicle screw fixation in treatment of traumatic thoracolumbar fracture without neurologie deficits. Methods From January 2007 through December 2007, there were 15 patients with traumatic fracture of the thoracic or lumbar spine without neurologie deficits treated within 10 days after injury. There were 10 males and 5 females at age range of 31-65 years (average 45.6 years). The fracture was located at T11 in 1, T12 in 4,L1 in 7, L2 in 2 and L3 in 1. Preoperative anteroposterior and lateral radiographs of the fractured spine as well as CT and MRI were done to evaluate injury severity of the vertebral body, spinal canal and diseolig-amentary structures. According to Magerl classification criteria, there were 10 patients with type A3 frac-ture, 3 with type A2 fracture and 2 with type A1 fracture, which were treated with pereutaneous posterior pediele screw fixation. Operative time and intraoperative blood loss were recorded to observe clinical re-suits. Results The average operation time was 82 minutes (65-110 minutes), with a mean intraopera-five blood loss of 35 ml (20-50 ml ). There were no conversions to open surgery, new neurological deficits or other surgery-related complications. All patients were followed up for 3-11 months (average 7.6 months), which showed that Cobb angle was corrected from preoperative (15.7±6.3)° to postoperative (3.5±1.2)°. Postoperative CT showed sound reduction of posterior bone displacement in all patients compared to preoperative CT results. Conclusions Percutaneous posterior pedicle screw fixation is fea-sible and safe surgical procedure with fine short-term outcome in treating traumatic thoracolumbar fracture without neurologic deficits. This technique offers serveral potential advantages over open approaches inclu-ding less tissue trauma and blood loss as well as quicker recovery.