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Minimally invasive reduction and percutaneous posterior fixation of one-level traumatic thoraco-lumbar and lumbar spine fractures

  • Original Article • SPINE - FRACTURES
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Although open procedures are the gold standard, the alternative approach of minimal invasive reduction using percutaneous screws for thoracic and lumbar spine fractures is under discussion. Aim of this study was to investigate the results of reduction and the accuracy of screw placement in minimally invasive percutaneous posterior instrumentation for these fractures.

Materials and methods

One hundred and twenty-seven patients with thoraco-lumbar and lumbar burst fractures and minimal invasive dorsal instrumentation were analyzed retrospectively in terms of the accuracy of pedicle screw placement and results of fracture reduction.

Results

In total, 542 screws were placed. Thirty-four (6.3%) screws of 22 patients (17.3%) were misplaced, but misplacement was minimal, replacement of any screw position due to instability was not necessary, and no new neurological deficit occurred. In thoraco-lumbar fractures (82/64.5%), reduction succeeded from 2.5 ± 6° kyphosis to 5.6 ± 5.7° lordosis (p < 0.001) and in lumbar spine fractures from 6.9° ± 10.3° lordosis to 14.5° ± 8.8° lordosis (p < 0.001).

Conclusion

Minimal invasive percutaneous dorsal instrumentation of burst fractures of the thoraco-lumbar and lumbar spine provides adequate reduction and reliable regular screw placement.

Level of evidence

Level IV (retrospective series).

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, Sinsheim Hospital, Alte Waibstadter Straße 2, 74889, Sinsheim, Germany

    Marco Tinelli

  2. Department of Trauma and Orthopaedics, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany

    Marco Tinelli, Friederike Töpfer, Michael Kreinest, Stefan Matschke & Paul A. Grützner

  3. Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Stefan Matschke & Arnold J. Suda

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Contributions

All authors have made substantial contributions to the conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content and approved the version to be submitted.

Corresponding author

Correspondence to Arnold J. Suda.

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The authors have no conflicts of interest.

Ethical approval

The study was approved by the local ethical committee Ethik-Kommission der Landesärztekammer Rheinland-Pfalz, Germany.

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Tinelli, M., Töpfer, F., Kreinest, M. et al. Minimally invasive reduction and percutaneous posterior fixation of one-level traumatic thoraco-lumbar and lumbar spine fractures. Eur J Orthop Surg Traumatol 28, 1581–1587 (2018). https://doi.org/10.1007/s00590-018-2224-9

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  • DOI: https://doi.org/10.1007/s00590-018-2224-9

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