Abstract
Objective: To evaluate the preliminary results of the surgical treatment through minimally invasive fixation technique in patients with thoracolumbar spinal fractures. Methods: Retrospective study of 17 patients with fractures of thoracolumbar vertebrae who underwent surgery with percutaneous fixation in the period of 2009 to 2011. The clinical evaluation of the results was performed using the SF-36 and Oswestry questionnaires. The radiographic parameters evaluated were: fracture classification according to Magerl's criteria, wedge angle of the fractured vertebrae and bisegmental Cobb angle. These measurements were made in the preoperative, immediate postoperative and 1 year after surgery. Other data such as associated injuries, neurological deficit, post-surgical infection, loosening and breakage of implants were also considered. Results: The data revealed average scores above 80% in all domains of the SF-36 questionnaire while in Oswestry Questionnaire, 79% of patients had minimal or absent physical limitations with a mean score of 12.4±11.89%. The average Cobb angle for preoperative kyphosis was 5.53º±13.80o, 2.18º±13.38o in the early postoperative period and 5.26º±13.95o one year after surgery. The average correction obtained after surgery was 3.35º and the average correction loss was 3.19º. No complications such as post-surgical infection, permanent neurological deficits and implant loosening and breakage were observed. Conclusion: The surgical treatment of fractures of thoracolumbar vertebrae using a minimally invasive technique provides satisfactory clinical and radiographic results with low complication rates.
Highlights
Surgical treatment of thoracolumbar fractures of the spine is usually necessary when there is impaired biomechanical stability, or existing or imminent neurological deficit, compression of the vertebral canal, or associated injuries that prevent conservative treatment.[1]
We conducted a retrospective study of patients diagnosed with thoracolumbar spinal fractures who underwent spine surgery using a minimally invasive technique during the period from 2009 to 2011 and who are included in a prospective database
One case of neurological deficit was observed during the preoperative period (Patient 16), with reduced strength at the L4 level
Summary
Surgical treatment of thoracolumbar fractures of the spine is usually necessary when there is impaired biomechanical stability, or existing or imminent neurological deficit, compression of the vertebral canal, or associated injuries that prevent conservative treatment.[1]. Current treatment options include conservative treatment with or without the use of ortheses,[4] conventional open approaches with the use of instrumentation and arthrodesis,[5] and more recently, minimally invasive posterior fixation techniques,[6,7,8,9,10] kyphoplasty, and vertebroplasty.[11] there is insufficient evidence in the literature to determine which of the different treatment methods is the best.[2]. Conservative treatment of thoracolumbar spine fractures requires prolonged restriction of activities, which often means absence from work and even bed rest, with its inherent complications. Other challenges are difficulty in controlling resulting deformities, and lack of patient understanding and cooperation.[5,12]
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