Réduction et fixation percutanée par voie postérieure des fractures thoracolombaires de type « burst » (éclatement)

Abstract

BackgroundTreatment of A3 thoracolumbar and lumbar spinal fractures nowadays remains a controversial issue. Percutaneous techniques are becoming very popular in the last few years to reduce the approach-related morbidity associated with conventional techniques. HypothesisPurpose of the study was to analyze the clinical and radiological outcome of patients who underwent percutaneous posterior fixation without fusion for the treatment of thoracolumbar and lumbar A3 fractures. Materials and methodsSixty-three patients, having sustained a single-level thoracolumbar fracture, underwent short segment percutaneous instrumentation and were retrospectively analyzed way. Sagittal Index (SI) was calculated in all patients. Clinical and functional outcome were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form General Health Status (SF-36). ResultsAverage operative blood loss was 82mL (50–320). Mean pre-operative SI in the thoraco-lumbar segment was 13.3° decreased to 5.8° in the immediate post-operative with a mean deformity correction of 7.5. Mean pre-operative SI in the lumbar segment was 16.5° decreased to 11.3° in the immediate post-operative with a mean deformity correction of 5.2. Not statistically significant correction loss was registered at 1year minimum follow-up. Constant clinical conditions improvement in the examined patients was observed. ConclusionPercutaneous pedicle screw fixation for A3 thoracolumbar and lumbar spinal fractures is a reliable and safe procedure. Level of evidenceLevel IV. Retrospective study.