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Journal of Neurosurgical Sciences 2018 Jun 14

DOI: 10.23736/S0390-5616.18.04439-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Accuracy of percutaneous pedicle screws for thoracic and lumbar spine fractures compared with open technique

Igor PAREDES 1 , Irene PANERO 1, Santiago CEPEDA 2, Ana M. CASTAÑO-LEON 1, Luis JIMENEZ-ROLDAN 1, Ángel PEREZ-NUÑEZ 1, Jose A. ALÉN 1, Alfonso LAGARES 1

1 Neurosurgery, "2 de Octubre" University Hospital, Madrid, Spain; 2 Neurosurgery, "Rio Hortega" University Hospital, Valladolid, Spain


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BACKGORUND: This study aimed to compare the accuracy of screw placement between open pedicle screw fixation and percutaneous pedicle screw fixation (MIS) for the treatment of thoracolumbar spine fractures (TSF).
MATERIALS AND METHODS: Forty-nine patients with acute TSF who were treated with transpedicular screw fixation from January 2013 to December 2016 were retrospectively reviewed. The patients were divided into Open and MIS groups. Laminectomy was performed in either group if needed. The accuracy of the screw placement, the evolution of the Cobb sagital angle postoperatively and at 12-month follow up and the neurological status were recorded. AO type of fracture and TLICS score were also recorded.
RESULTS: Mean age was 42 years old. Mean TLICS score was 6,29 and 5,96 for open and MIS groups respectively. Twenty five MIS and 24 open surgeries were performed, and 350 (175 in each group) screws were inserted (7,14 per patient). Twenty-four and 13 screws were considered ̈out ̈ in the open and MIS groups respectively (Odds ratio 1,98. 0,97-4,03 p=0,056). The Cobb sagittal angle went from 13,3o to 4,5o and from 14,9o to 8,2o in the Open and MIS groups respectively (both p<0,0001). Loss of correction at 12-month follow up was 3,2o and 4,2o for the open and MIS groups respectively. No neurological worsening was observed.
CONCLUSIONS: For the treatment of acute thoracolumbar fractures, the MIS technique seems to achieve similar results to the open technique in relation to neurological improvement and deformity correction, while placing the screws more accurately.


KEY WORDS: Thoracolumbar fractures - Minimally invasive surgery - Percutaneous screw placement - Screw accuracy - Neurologically impaired - Angle correction

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