Chance Fracture Research Articles

Postmortem CT and autopsy findings in an elevator-related death: a case report

AbstractElevator-related fatalities and injuries are rarely discussed. Falls have been identified as the first cause of mortality in the majority of these accidents. Evidence suggests that many elevator accidents may be attributed to inadequate equipment maintenance or malfunctions of the devices. This study examines a case involving an elevator maintenance worker found within an elevator shaft, using postmortem computed tomography (PMCT) along with a full autopsy. The autopsy revealed that the cause of death was severe polytrauma resulting from dragging, compression, and crushing mechanisms, which resulted in a dislocated skull and multiple thoraco-abdominal injuries, including exposed organs and viscera. Detailed examination identified a cranio-encephalic crush, leading to a significant alteration in the physiognomy of the facial structures. Additionally, PMCT revealed complex spinal fractures, such as a Jefferson fracture and a complete Chance fracture at the D6 vertebra, accompanied by spinal deviation proximal to the fracture site. Autopsy findings corroborated these PMCT results. A multidisciplinary approach, including PMCT, is proposed as a strategic method for the comprehensive reconstruction of such accidents, facilitating the collection of extensive data.

Minimally Invasive Techniques in the Surgical Management of Traumatic Pediatric Thoracolumbar Fractures

BackgroundThoracolumbar (TL) fractures are uncommon injuries in children. While surgical treatment is recommended for unstable TL fractures, there is no consensus on the appropriate surgical treatment. We present a case series of pediatric patients with traumatic TL fractures treated with minimally invasive (MI) surgical techniques. We discuss our early experience and technical challenges with navigation and robot-assisted (RA) fixation, which has not been reported in young children. MethodsA retrospective review of a prospectively maintained trauma database from February 2018-February 2023 of all pediatric patients (< 18 years old) undergoing percutaneous fixation for unstable TL fractures was performed. MI techniques included fluoroscopy and/or navigation-guided or RA. Details of the clinical course, radiographic findings and technical challenges were reviewed. ResultsA cohort of 12 patients with ages ranging from 4-17 years of age were identified. There was a total of 6 (50%) Chance fractures, 2 (16%) pars, 2 (16%) pedicles, 1 (8%) burst, and 1 (8%) other fracture. 9 patients had fractures involving the lumbar spine and the remaining 3 had thoracic fractures. In all cases, percutaneous pedicle screws were placed above and below the fracture with the use of neuro-navigation or RA navigation (n=2). Blood loss was less than 30 milliliters (ml) for single level fractures and instrumented fusion. Two patients had hardware-related complications. At follow-up, (mean 9.67 months from surgery) most of the radiologic imaging showed stable alignment and patients were doing well clinically. ConclusionsOur early experience shows that short segment instrumentation through a MI approach is a safe and effective surgical option for young pediatric patients with good clinical outcomes and favorable radiographic post-operative finding.

Pediatric CHANCE fracture treated by lumbar lacing technique: a case report

This paper presents the case of an 7-year-old girl victim of a road accident. The neurological examination revealed a conscious patient without any sensory or motor deficit and she had intense lumbar pain. The lumbar computed tomography scan found a chance fracture at the level of L3. the patient was operated under general anaesthesia with a sublaminar lacing fixation of L2–L3 similar to the lacing of C1C2 in upper cervical trauma. The follow-up was good The control X-ray was satisfied with a complete reduction and restoration of the lumbar lordosis and the patient was discharged from the hospital on the fifth day following the intervention. this article shows that sublaminar lacing can be as effective as pedicle screw fixation, thus preserving bone growth

Flexion–distraction injuries of the spine: Features of diagnostics, clinical picture, and results of surgical treatment of children

BACKGROUND: Flexiondistraction injuries of the spine result from high-energy trauma (traffic accidents and falls from a height). This type of injury is commonly found in the thoracolumbar junction. Among combined injuries in the presence of flexiondistraction fractures of the vertebral column, injuries of the chest or abdominal organs are often observed, which are crucial for patient survival, and their diagnostic measure is complex because of the severe and unstable conditions of the patients.&#x0D; AIM: To analyze a cohort of pediatric patients who underwent surgery for flexiondistraction injury of the spine.&#x0D; MATERIALS AND METHODS: We analyzed the data of clinical and instrumental studies and surgical outcomes of 28 pediatric patients (aged 217 years) with flexiondistraction injuries of the spine. The standard preoperative examination included clinical and laboratory studies, spondylography, multislice spiral computed tomography and magnetic resonance imaging of the damaged area, electrocardiography, and ultrasonography of the abdominal organs and kidneys. All patients underwent surgery for the correction and stabilization of traumatic spinal deformity with a multisupport metal structure and posterior local fusion. The analysis included an assessment of the mechanism of injury, concomitant injuries, time elapsed after the injury before admission to the hospital, level of the damaged segment, and treatment. Data were processed statistically using an online calculator. The nonparametric MannWhitney method was used.&#x0D; RESULTS: Catatrauma was the leading cause of injury in 50% of the patients, compared with traffic accidents in 36%. In 80% of the patients, spinal injury was localized at the thoracolumbar junction and lumbar spine. Moreover, 71% of the patients were transferred to the National Research Center for Childrens Orthopedics and Trauma Surgery for surgical treatment on the spine in the early stages after injury (up to 7 days), and 8 children (19%) were admitted within 1045 days (average 16 days). In 19 (68%) patients, in addition to spinal injury, concomitant injuries occurred, with skeletal trauma and injuries of the abdominal cavity organs as the most frequent. All patients achieved complete correction of the deformity at the level of the damaged segment.&#x0D; CONCLUSIONS: Flexiondistraction fractures of the spine in children are characterized by a high incidence of concomitant injuries, which dictates the need for a full examination to identify them and correctly interpret the data. The elimination of mechanical instability in the early stages in this type of injury can reduce the extent of fixation and contribute to the restoration of the physiological profile and disk apparatus of the spinal column.

Screw fixation without fusion for low lumbar chance fracture accompanied by spinal epidural hematoma in patient with ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory disease involving the sacroiliac joint and axial spine. AS may render the ankylosed spine prone to trauma and cause an increased frequency of associated epidural hematomas in spine fractures. Herein, we report a rare case of L5 chance fracture and epidural hematoma in a 27-year-old female patient with AS. She was treated surgically but without bone fusion or decompressive laminectomy due to the neurologically intact status despite significant neural compression by the spinal epidural hematoma (SEH). We believe that conservative treatment with close observation of neurological status may be effective in SEH presenting with mild neurological symptoms despite significant neural compression.

438 Benefits of Short- Versus Long-segment Fixation for the Treatment of Thoracolumbar Chance Fractures: A Comparison of Perioperative and Radiological Outcomes

INTRODUCTION: Discussion continues regarding optimal surgical management of thoracolumbar fractures. Some have indicated long-segment posterior fixation (LSPF) is favorable when evaluating implant stability, kyphotic deformity, and pain. However, most studies either included multiple fracture subtypes or focused on burst fractures. Short-segment fixation (SSPF) may be similarly effective for a subset of patients while minimizing surgical time and length of stay (LOS). This study reviews inpatient and follow-up outcomes of chance fractures managed with SSPF versus LSPF. METHODS: Retrospective review of 50 consecutive patients with thoracolumbar distraction injuries (AO B1 and B2) at a single center over a five-year period. Patients underwent pedicle fixation one level (SSPF) or two to three levels (LSPF) above and below the fracture. Patient demographics, preoperative characteristics, and perioperative outcomes were compared between groups. Radiological outcomes were assessed by measuring Cobb angles immediately postoperatively and up to 12 months postoperatively. RESULTS: There was a 31% reduction in mean surgical time for SSPF patients vs LSPF (134 vs 195 minutes, independent samples t test, p = 0.037) without a significant difference in ICU LOS (4.6 vs 4.8 days, independent samples t test, p = 0.947), hospital LOS (15 vs 14 days, independent samples t test, p = 0.865) or complication rates (2 of 35 vs 2 of 15 patients, Fisher’s Exact, p = 0.574). Longitudinal assessment of kyphosis by measuring Cobb angles immediately postoperatively and 2 - 4, 6, 8 - 12, and &gt; 12 months postoperatively showed no significant differences in radiological outcomes between groups. There was a trend toward an increased likelihood of discharge to home (Likelihood ratio = 5.299, ꭓ2 test, p = 0.032) with SSPF. CONCLUSIONS: SSPF is non-inferior to LSPF for thoracolumbar chance fractures while offering reduced surgery time. Our results additionally suggest SSPF may offer increased likelihood of discharge home.

Endovascular Aortic Repair for Thoracic Aortic Compression Resulting From Chance Fracture of the Thoracic Spine

Blunt aortic injury is a serious condition with a high mortality rate. Although rare, blunt aortic injury associated with spinal fracture has also been reported, and appropriate management of aortic disease is key to a good outcome. This report is a case of a 78-year-old man who was found to have a transverse fracture (Chance fracture) in the ninth thoracic vertebra, with a sharp bone fragment compressing the thoracic aorta. Early spinal surgery was needed; however, there was concern about the possibility of bleeding from the aorta and surrounding small arteries associated with the bone fragment during spinal surgery. Therefore, thoracic endovascular aortic repair was performed before spinal surgery. The next day after thoracic endovascular aortic repair, posterior spinal instrumentation was performed, and the postoperative course was uneventful. Because aortic injury associated with vertebral fracture can lead to massive bleeding and spinal cord injury, endovascular repair before spinal surgery is reasonable.

Air Crash Investigation: Pattern of Spinal Injuries, Management During the COVID-19 Pandemic, and Outcomes.

Spinal injuries following an air crash can be fatal, and recognizing the patients who need immediate attention and early management could save those patients from ending up with lifelong disabilities and other consequences. However, taking appropriate actions in a pandemic situation presents additional challenges. We present our report of air crash victims with spinal injuries, along with their patterns, morphology, management, and outcomes during the COVID-19 pandemic. An analysis was performed on the spinal injuries of victims of the Boeing 737 crash landing at the Karipur Airport (Calicut International Airport, Kerala, India) who were treated at a tertiary care referral hospital in August 2020. Details of the initial triage, patterns of injury, morphologies, mechanisms, management principles, and outcomes at 9 months postinjury were recorded and analyzed. Of the 47 patients received at our center, 44 survivors were triaged and 13 patients (29.5%) were identified to have spinal injuries of varying severities. The majority of the injuries were chance fractures at the lumbar level, followed by burst and compression fractures. A total of 6 patients underwent surgery, following all COVID-19 guidelines based on priority. All survivors had positive outcomes with our management. No complications such as secondary infections, worsening of neurological deficits, or implant failures were recorded. A high incidence of spinal injuries is seen in air crash victims. Early prioritized surgical management in selected patients provides excellent outcomes. Disaster management during a pandemic situation is a difficult task, where proper planning and execution is necessary to provide optimal results.

Early Imaging Identification of Traumatic Mesenteric and Bowel Injury: An illustrative case of bucket-handle mesenteric avulsion injury with delayed presentation as small bowel obstruction

Traumatic small bowel and mesenteric injuries (SBMI) are uncommon sequelae of blunt trauma. Imaging findings in SBMI can be subtle with varying degrees of sensitivity and specificity, requiring a high level of suspicion given the high associated morbidity and mortality. Imaging findings include seat-belt distribution subcutaneous edema, flexion-distraction fractures, free fluid without a source, asymmetric bowel wall thickening, interloop edema, bowel ischemia, pneumoperitoneum, and even delayed bowel obstruction. A specific subtype of SBMI is an avulsion injury of the small bowel mesentery, which is described as a “bucket handle” defect within surgical literature. This case report highlights the temporal evolution of imaging findings present in cases of traumatic SBMI and is illustrative of how those clinical and imaging findings can inform management decisions.

Extended pedicle subtraction osteotomy in combination with novel four-rod technique in an ankylosing spondylitis patient with neglected thoracolumbar fracture: a case report

Introduction: Ankylosing spondylitis is an autoimune disorder that affects mainly the enthesis of the spinal ligaments and capsules and causes a progressive fusing of the vertebra bodies. The ankylosed spine will lose the ability of absorbing and dissipating the axial loading force and therefore becomes vulnerable with injuries. Case report: We report a 27-year-old male patient with past history of ankylosing spondylitis who suffered from a neglected thoracolumbar fracture after a traffic accident one year before admission. He noticed an ongoing kyphotic deformity over time to the point that he could not have a horizontal gaze at present. The full spine Xray depicted a severe kyphosis at L1/2 (80o ) due to a nonunion L1/2 flexion-distraction fracture. There were no neurological deficits at admission. Surgical treatment and outcome: The patient underwent an extended L2 pedicle subtraction osteotomy and long instrumentation from T10 to L5. The clinical and radiological outcome were satisfactory as the global kyphosis was reduced from 80o to 20o and patient could regain his normal upright posture, even better than before the accident. Conclusion: Kyphotic deformity in ankylosing spondylitis patients, especially with traumatic causes is always a challenge for spinal surgeons as corrective surgeries involve potential neurological complications. Conventional pedicle subtraction osteotomy remains a procedure of choice. The downside of this technique is the relatively high risk of non-union and implant failure which can be improved by reinforcing two additional short rods to the whole configuration.

Difference in Presentation and Concomitant Intra-Abdominal Injury with Chance Fracture in Pediatric and Adult Populations.

Chance fracture (CFx) with concomitant intra-abdominal injury has variable occurrence rates ranging from 33 to 89%. No single study has compared the incidence of simultaneous abdominal injury between pediatric and adult populations. This study compares the rate of simultaneous intra-abdominal injury and chance fracture in these populations. A retrospective review of pediatric and adult patients with chance fracture in comparable pediatric and adult trauma centers was performed. Patient demographics, mechanism of injury (MOI), and injury patterns were collected from 2002 to 2019 for pediatric patients and 2015 to 2018 for adults. Student t-test analyses were performed to determine statistical significance between the cohorts. The pediatric group had a similar incidence of abdominal solid organ injuries compared to adults (16 [20.5%] vs. 40 [19.7%], p<0.879), but the pediatric group had a greater number of total intra-abdominal (49 [62.8%] vs. 47 [23.1%], p < 0.001) and hollow organ injuries (40 [51.3%] vs. 17 [8.4%], p < 0.001). Motor vehicle collision was the most common mechanism of injury for both groups (72 pediatric [92.3%] vs. 85 adult [41.7%]) but adults suffered from more falls (3 pediatric vs. 81 adult, p < 0.001). Pediatric patients with CFx caused by MVCs had more intra-abdominal injuries (48 [66.7%] vs. 25[29.8%], p < 0.001) and hollow organ injuries compared to adults (39 [54.2%] vs. 8[9.5%], p < 0.001). In the setting of Chance fracture after trauma, pediatric patients are more likely to have a concomitant intra-abdominal organ injury (63% vs. 23%), especially hollow viscus injury (51.3% vs. 8.4%) compared with adults regardless of mechanism.

Awake Percutaneous Fixation for Unstable Fractures of the Spine in High-risk Patients: A Retrospective Study.

Unstable fractures in sick or elderly patients are on the rise. These patients who are at high risk for surgery present a challenge for surgeons and anesthesiologists. In patients with American Society of Anesthesiologists (ASA) scores 3 to 4, the risk is even higher because of the high rate of intraoperative complications. All patients with ASA scores 3 to 4 who presented with unstable fractures of the spine to a level-one trauma center were assessed, and they underwent awake spinal percutaneous fixation, with mild sedation and local anesthesia. Demographics, radiology, and the outcome were collected. Nineteen patients were operated between the years 2019 and 2021. Average follow-up was 12 months (range 8 to 24 months); six patients were female and 13 males. The average age was 77.7 years; the ASA score was 3 to 4 in all patients. There were 10 extension-type injuries, six unstable burst injuries, two chance fractures, and one teardrop fracture. All patients underwent unilateral fixation, and just one patient underwent bilateral fixation; cement augmentation was done in 16 of the patients. No neurologic complication was observed. One case of infection presented 4 months after surgery. All patients were discharged ambulating. Awake fixation in extreme cases is safe and feasible; a dedicated team including an anesthesiologist and radiologist is needed to treat these cases safely and quickly.

A case of kyphosis deformity and vertebral osteotomy after Chance fracture due to young onset diffuse idiopathic skeletal hyperostosis

A case of kyphosis deformity and vertebral osteotomy after Chance fracture due to young onset diffuse idiopathic skeletal hyperostosis

Posterior segmental fixation for thoraco-lumbar and lumbar fractures: a comparative outcome study between open and percutaneous techniques

Purpose Showing results of open and percutaneous surgical management of traumatic AO type A3, A4 and B2 thoracic and lumbar fractures. Methods Retrospective comparative analysis of traditional open fusion versus percutaneous navigated fixation of thoracic and lumbar spinal fractures. Minimum 24 months follow-up to collect ODI and VAS outcome scores for comparative analysis was required. Results Fifty-seven patients with a mean age of 39 years met the inclusion criteria. Twenty-six patients were in the open group (Group O) and 31 in the percutaneous group (Group P). The majority of fractures were either type A3 or A4; there were three type B chance fractures in Group O and one in Group P. VAS and ODI scores followed comparable trends in the two groups until the final follow-up. The main statistically significant result between the two groups was blood loss, which was lower in Group P (110 versus 270 ml in Group O on average), although this did not reflect into different clinical outcomes. Similar peri-operative measures of operating time and length of stay were found between the two groups. A significantly higher degree of loss of reduction was noted at follow-up in Group P (8° versus 5° in Group O on average). Conclusions Open and percutaneous posterior fixation techniques of thoracic and lumbar fractures in this cohort were associated with different perioperative blood losses as well as radiological measurements, but not with clinically meaningful differences in patient reported outcome measures at 24 months’ follow-up.

Assessment of Chance fracture on Computed Tomography Scan in Tertiary Trauma Care Center of Nepal.

Introduction: Chance fracture is a horizontal fracture of the vertebra extending from the posterior element to the vertebral body due to flexion-distraction injury and is potentially unstable. The aim of this study was to evaluate the demography and Computed Tomography scan findings in Chance fracture of the spine. Method: A retrospective study was conducted at the National Trauma Center, National Academy of Medical Sciences over a period of one year (December 2019 to December 2020). Demographic data, mechanism of injury, and computed tomographic findings of Chance fracture were recorded. Result: Computed tomography scans of 41 patients with Chance fracture were identified. Fall injury (76%) was the most common cause of Chance fracture followed by road traffic accidents. This fracture was most commonly seen in thoracolumbar junction TLJ (D10-L2); with L1 being the most affected vertebra (36.5%). Among posterior elements, facet distraction (84%) was the most common finding followed by lamina fracture (83%), and pedicle fracture (68%). Regarding vertebral body fracture, involvement of both superior and inferior endplates were common than isolated involvement of either one of them. CT revealed that a burst component was a common finding (68%) in Chance fracture. Conclusion: Chance fracture was commonly caused by fall injury in our context which is higher in incidence than previously reported. More than half of patients with Chance fracture also had Burst-type components that could influence surgical management. Computed tomography scans is a useful imaging modality for the assessment of Chance fracture and burst component.

Epidemiology of spinal fractures in children: Cross-sectional study

IntroductionEpidemiological studies of fractures of the spine in children are all old, mostly single-centre, with series spanning periods of 5 to 20 years. HypothesisAs lifestyle is constantly changing, notably with an increase in sports activities and improvements in the prevention of road and household accidents, epidemiology has likely changed. ObjectiveTo update the description of spinal trauma in children and adolescents compared to the existing literature. Material and methodA multicentre cross-sectional study of spinal fracture, dislocation and spinal cord injury without radiological abnormality (SCIWORA) in children was carried out in 15 French university hospital centres, for a period of one year (2016). ResultsOne hundred and sixty-five children were identified: 85 girls, 80 boys; mean age 11 years (range, 10 months–17 years); median, 12 years 6 months. One hundred and fifty-two children (92%) had fracture, 8 (5%) dislocation (including 7 C1-C2 rotary dislocations), and 5 (3%) SCIWORA. Fractures were multiple in 80 cases (49%), contiguous in 73 cases (91%) and non-contiguous in 7 (9%). Locations were cervical in 25 cases (15%), thoracic in 85 (52%), lumbar in 75 and sacral in 4 (2%). Fracture types comprised 234 vertebral compactions (78%), 25 burst fractures (8%), 5 chance fractures (2%), 2 odontoid fractures, and 33 other lesions. Causes comprised fall in 77 cases (47%), sports accidents in 56 (34%), road accidents in 29 (18%), and others in 3. In 52 cases (32%), there was ≥1 associated lesion: appendicular in 35 cases (67%), thoracic or abdominal in 31 (60%), and head in 16 (31%). Twenty-one cases had multiple lesions (40%). Eighteen cases showed neurological involvement (11%) including 5 SCIWORAs. Neurological complications were more frequent before 9 years of age. ConclusionThe epidemiology of spine fractures in children has slightly changed. There are now fewer cervical lesions. Causes are less often road accidents and more often sports accidents. Multi-level lesions remain frequent and the rate of neurological complications is around 10%. Compaction fracture is the most common type.

Spinal Flexion Distraction Injuries: Chance Fractures and Posterior Ligamentous Equivalents in Children and Adolescents

Flexion-distraction injuries (FDI) are uncommon and often serious due to the mechanism of injury. Although originally described as a bony lesion in the thoracolumbar spine, these injuries can be purely bony, purely ligamentous/soft tissue or a combination at all spinal levels. Because of the forces involved, associated non-spine injuries can occur. Data on patients age 0-18 years with spinal injuries over a ten-year period were retrospectively reviewed and patients were classified into two groups, those with FDI and those with a spinal fracture other than FDI. Cervical and thoracic FDI, Chance fractures and posterior ligamentous equivalents, all considered FDI in this study, occurred in 22/301 spinal injured patients. The highest incidence considering all spinal injured patients was in the under 10 years old group (31.6%; p=0.004). A motor vehicle collision was the most common mechanism of injury. Statistically significant differences between patients with FDI compared to those without were respectively: average age (13.7 vs. 15.6 years), length of stay (10.2 days vs. 4.0 days), follow-up (1.7 years vs. 0.5 years), spinal surgery (78.3% vs. 15.5%), intra-abdominal organ injury (26% vs. 11%) and neurological deficit at presentation (43% vs. 10.4%) and at final follow-up (22% vs. 4%). Five patients without neurologic deficit did not undergo surgery.Seventy-two percent (13/18) of FDI patients having surgery required instrumentation. There was no association between injury level and FDI incidence or neurological deficit. FDI are most common in younger children with high likelihood of associated injuries, including intra-abdominal and neurological. FDI patients most often require surgical treatment, have an increased length of hospital stay and require longer-term follow-up.

Flexion-distraction Fracture of the Pelvis: Review of the Literature and a Conceptual Classification

Flexion-distraction Fracture of the Pelvis: Review of the Literature and a Conceptual Classification

Aggressive Thoracic Hemangioma Leading to Secondary Kyphosis with Paraparesis in the Postpartum Period. A Case Report

Aggressive vertebral hemangioma is rare, and its management can be very challenging. In this report, we present the case of a 30-year-old female with a normal twin pregnancy. She had been complaining of midthoracic pain after the seventh month of pregnancy with no other symptoms. Normal delivery was done under spinal anesthesia, but the patient's back pain worsened after the delivery, and she left the hospital on Day 4 with the onset of an unsteady gait. She was seen in the spinal clinic on Day 14, referred by her gynecologist, with a paraparetic presentation that was rapidly worsening. Urgent magnetic resonance imaging (MRI) was done and revealed aggressive hemangioma of T6 with kyphosis and significant cord compression. The patient was admitted and was operated the following morning. Posterior decompression with fixation from T4 to T8 and kyphosis correction was done. Samples from the vertebrae were sent to the lab for pathology analysis, and the results confirmed the diagnosis of vertebral hemangioma. She could walk on Day 1 with progressive neurological recovery, but distal junctional kyphosis in the form of a "chance fracture" of T8 occurred at 2 months and was treated conservatively. She showed a satisfactory clinical and radiological result at 2 years with no recurrence. Literature is sparse on the management of vertebral hemangioma in the context of pregnancy and postpartum, with only case reports, and its presentation as a kyphotic fracture is extremely rare. The current case shows how, in the context of delivery, a benign procedure such as spinal anesthesia should be done with extreme caution, as it may play a role in aggravating an undiagnosed aggressive hemangioma; rapid management after the onset of paraparetic symptoms enables a full neurological recovery, but close monitoring later on with regular MRI is mandatory for detection of any recurrence.

Minimally Invasive Surgery in Treatment of Traumatic Thoracolumbar Spinal Injuries: A 2-Year Experience

Introduction: Majority of the traumatic spine injuries are located at the thoracolumbar region. They can be compression fractures, burst fractures, flexionextension injuries (Chance fractures), dislocations, or any of the combination. Surgery is indicated for patients with thoracolumbar injury classification scoring (TLICS) of 4 or more. Traditionally, surgical approaches for thoracolumbar spinal injuries involve open surgery, instrumentation with/without decompression. In our previous study, open surgery for traumatic thoracolumbar injuries and history of blood transfusion have been found to be associated with higher risk of deep surgical site infection requiring surgical debridement. With the advent of modern implants and equipments, minimally invasive surgery (MIS) has been made possible for spine surgeries. We report our two-year experience in utilizing MIS to treat traumatic thoracolumbar spinal injuries. Materials and method: Patients who underwent spinal surgeries at Hospital Tengku Ampuan Afzan, Kuantan from July 2017 to July 2019 were screened for suitability to be included in this study. Only patients who underwent spinal minimally invasive surgeries have been included in this study. Patients who underwent open spinal surgeries were excluded. Results: A total of 8 patients were included in this study. There were 3 burst fractures and 5 chance fractures. All patients underwent a minimum of 4-level posterior spinal instrumented fusion with MIS techniques and 2 patients had laminectomy at the injured level for decompression. All but one patient did not require blood transfusion and there was no incidence of surgical site infection among these patients. Conclusion: Minimally invasive surgery (MIS) is a better option compared to open surgery in treating traumatic thoracolumbar spinal injuries. By minimizing the surgical incision, we are able to reduce blood loss and avoid deep surgical site infection.