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European Journal of Orthopaedic Surgery & Traumatology
Published in: European Journal of Orthopaedic Surgery & Traumatology 5/2018

01-07-2018 | Original Article • SPINE - MINIMAL SURGERY

Minimally invasive fixation techniques for thoracolumbar fractures: comparison between percutaneous pedicle screw with intermediate screw (PPSIS) and percutaneous pedicle screw with kyphoplasty (PPSK)

Authors: Gaetano Caruso, Enrica Lombardi, Mattia Andreotti, Vincenzo Lorusso, Alessandro Gildone, Sara Padovani, Leo Massari

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2018

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Abstract

Purpose

To assess and compare the efficacy of two minimally invasive techniques (percutaneous pedicle screw with intermediate screw vs. percutaneous pedicle screw with kyphoplasty) for spinal fracture fixation by comparing the segmental kyphosis and vertebral kyphosis angles after trauma before surgery, after surgery, and at 4-month and 12-month follow-up.

Methods

Data from 49 patients without neurological deficit treated by either percutaneous pedicle screw with intermediate screw or percutaneous pedicle screw with kyphoplasty were retrospectively analysed. The segmental kyphosis and vertebral kyphosis angles over time were calculated and correlated with the type of procedure, AO classification, lumbar or thoracic site and the age and sex of the patients.

Results

After surgery, both techniques were found to be efficacious means of bringing about a significant correction of the segmental kyphosis angle (p = 0.002) and a just significant correction of the vertebral kyphosis angle (p = 0.06), although less effectively in thoracic fractures (p = 0.004). At follow-up, the vertebral kyphosis angle was stable in both groups, while there was a significant loss of segmental kyphosis angle stability in the percutaneous pedicle screw with kyphoplasty group at 1 year (p = 0.004); fractured thoracic vertebrae maintained a greater vertebral kyphosis angle (p = 0.06) and segmental kyphosis angle (p < 0.001), than the lumbar.

Conclusion

At 1 year after surgery, the use of intermediate screws in fractured vertebrae seemed to maintain a more efficacious correction with respect to kyphoplasty, although thoracic fracture sites appear to be associated with greater post-traumatic segmental kyphosis and lesser stability in the long term after both percutaneous surgical techniques.
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Metadata
Title
Minimally invasive fixation techniques for thoracolumbar fractures: comparison between percutaneous pedicle screw with intermediate screw (PPSIS) and percutaneous pedicle screw with kyphoplasty (PPSK)
Authors
Gaetano Caruso
Enrica Lombardi
Mattia Andreotti
Vincenzo Lorusso
Alessandro Gildone
Sara Padovani
Leo Massari
Publication date
01-07-2018
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2018
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-018-2122-1

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