Kaisorn L. Chaichana, Rafael De la Garza-Ramos, Daniel M. Sciubba, Ziya L. Gokaslan and Ali A. Baaj
Study background: Thoracolumbar fractures are among the most common type of traumatic spine fractures. The use of minimally invasive, percutaneous pedicle screw fixation for these fractures has been limited to case reports and small case series. The efficacy of this approach remains unclear. Methods: The evaluation and management of a patient with traumatic T12 burst fracture is presented. In addition, a literature review of the Medline and PubMed databases was conducted. Results: A total of 166 patients from 8 studies were identified. Average age was 46 years. Polytrauma was reported in 27% of patients. Average surgery time was 91 minutes, with an average blood loss of 95 milliliters. Reported complications were non-healing fracture in 3(2%), infection in 1(0.6%), mal-positioned screw in 1(0.6%), and hematoma in 1(0.6%) at a median follow-up time of 26 months. Pain improved by an average of 6 points after surgery according to visual analog score, and mean kyphosis correction in these studies was 8.5°. Conclusions: This review demonstrates that minimally invasive, percutaneous pedicle screw fixation is a viable option for the management of traumatic thoracolumbar fractures in neurologically intact patients. Patients who are older and/or present with polytrauma may most benefit from this type of intervention.
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