Percutaneous Posterior Fixation for Treatment of Thoracolumbar Fractures
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- Category: Vol. 80, December 2012
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Percutaneous Posterior Fixation for Treatment of Thoracolumbar Fractures,AHMED ELSAWAF and TAREK E. ELSHAFEE
Abstract
Object: Many complications have been commonly seen after posterior pedicle instrumentation for a thoracolumbar fracture. The newly used percutaneous technique seems to be beneficial in this issue. The aim of this study was to investigate the approach, its benefits, hazards and difference in outcome form ordinary open posterior fixation.
Methods: Seventeen patients who had undergone posterior percutaneous screw fixation for thoracolumbar burst fractures (T 12-L2) were investigated prospectively. The mean follow-up period was 2 years (mean 18.2 months). Pain was assessed using visual analogue scale. Complete neurological examina-tion assessed by Frankle grading system was done, also operative, measures; Duration of surgery, Hospital stay, blood loss, time between surgery and mobilization of the patient, duration and intensity of postoperative pain, and surgical complications were all assessed. Changes in the anterior vertebral height ratio, Cobb angle, were measured preopera-tively, postoperatively, and at final follow-up. The canal decompression was also measured.
Results: Immediately after surgery, percutaneous approach had a significantly better results compared to open procedures, this was regarding to operative time, Hospital stay, early mobilization of the patient and postoperative pain. At the final follow-up, there was significant clinical and radiological improvement according to Frankle grading scale and measured Cobb angle and degree of canal encroachment respectively (p=0.001).
Conclusion: Surgeons who perform percutaneous posterior fixation procedures should understand that the procedure may be helpful for immediate postoperative outcome, better cost-benefit results, but no long term superiority over traditional open spinal fixation regarding either clinical or radiological outcome or back pain.