Marco Tinelli1,2, Friederike Töpfer2, Michael Kreinest2, Stefan Matschke2,3, Paul A Grützner2, Arnold J Suda4. 1. Department of Orthopaedics and Trauma Surgery, Sinsheim Hospital, Alte Waibstadter Straße 2, 74889, Sinsheim, Germany. 2. Department of Trauma and Orthopaedics, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany. 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. 4. Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. arnoldsuda@yahoo.com.
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).
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).
Authors: Michael Kreinest; Jan Rillig; Paul A Grützner; Maike Küffer; Marco Tinelli; Stefan Matschke Journal: Eur Spine J Date: 2016-12-15 Impact factor: 3.134
Authors: A P Verheyden; A Hölzl; H Ekkerlein; E Gercek; S Hauck; C Josten; F Kandziora; S Katscher; C Knop; W Lehmann; R Meffert; C W Müller; A Partenheimer; C Schinkel; P Schleicher; K J Schnake; M Scholz; C Ulrich Journal: Unfallchirurg Date: 2011-01 Impact factor: 1.000
Authors: Christoph Linhart; Christopher A Becker; Nima Befrui; Eduardo M Suero; Adrian C Kussmaul; Wolfgang Böcker; Christian Kammerlander; Axel Greiner Journal: In Vivo Date: 2022 Jan-Feb Impact factor: 2.155