A novel, percutaneous, self-expanding, forceful reduction screw system for the treatment of thoracolumbar fracture with severe vertebral height loss

Over the past decade, the techniques for minimally invasive spinal stabilization have improved significantly. The multiaxial screw utilized in minimally invasive operations is limited in restoring fracture height, reconstructing the anterior vertebral column, and improving kyphosis. Therefore, the percutaneous, minimally invasive approach is not recommended for a thoracolumbar fracture with severe vertebral height loss. We report our novel, percutaneous, self-expanding, forceful reduction screw system to address this problem.

The operation was completed successfully in 38 patients. A total of 152 screws were placed. The average operation time was 90.7 ± 21.9 min, and the average intraoperative bleeding amount was 89.2 ± 31.9 ml. The patients were discharged at a mean of 3.2 ± 0.9 postoperative days, with a mean hospital stay of 4.8 ± 1.0 days. The VBI, HAMFV, VBA, and BCA scores were significantly improved after treatment with the novel screw system; there was a significant difference between pre- and postoperative parameters (p < 0.05). Although the decreases in all of the parameters were variable during the 2-year follow-up, there were no statistical differences between the postoperative imaging parameters and the last follow-up imaging parameters (p > 0.05). The ODI score at the last follow-up examination was 5.9 ± 2.7, which was significantly improved compared with the preoperative score of 44.6 ± 2.3 (p < 0.05).

We believe that the novel, percutaneous, self-expanding, forceful reduction screw system developed by us not only successfully expands the minimally invasive percutaneous surgery to the thoracolumbar fracture with severe vertebral height loss but also achieves significant vertebral height restoration and kyphosis correction.