Minimally invasive surgical treatment of post-traumatic thoracolumbar kyphosis

Abstract

Objective To determine the safety and efficacy of minimally invasive surgical treatment for post-traumatic thoracolumbar kyphosis. Methods A retrospective review was performed on seven patients with post-traumatic thoracolumbar kyphosis admitted from April 2009 to February 2010.There were four males and three females, at average age of 45.3 years. After general anesthesia, minimally invasive transarticular osteotomy and multi-level SextantTM percutaneous reduction and internal fixation were performed under QuadrantTM working tube system. The status of pain and ability was evaluated by using visual analogue scale (VAS) and Oswestry disability index (ODI). The kyphotic deformity was evaluated by using the Cobb's angle. Results The operation lasted for mean 135 minutes, with mean perioperative blood loss of 106 ml but with no any complications occurred. The mean follow -up period was 5.5 months ( range 4 -16 months ). The mean VAS score was improved from preoperative ( 7.6 ±3.5) points to postoperative (2.5 ± 1.3) points, with statistical difference (P ＜0.01 ). The mean ODI was improved from preoperative 53.6 ± 24.2 to postoperative 20.6 ± 6.3, with statistical difference ( P ＜0.01 ). The Cobb angle was also improved from preoperative ( 32. 1 ± 4.5 ) ° to postoperative ( 7.3 ±2.9 ) °, with statistical difference ( P ＜ 0. 01 ). Conclusion Minimally invasive transarticular osteotomy under QuadrantTM working tube system is a safe and effective alternative for dealing with post-traumatic thoracolumbar kyphosis. Key words: Spinal fractures; Thoracic vertebrae; Lumbar vertebrae; Surgical procedure,minimally invasive