Percutaneous pedicle screw fixation in polytrauma patients

Abstract

Purpose: The clinical outcome of polytrauma patients underwent spine fixation was analyzed and correlated both to surgical time (early versus delayed) and to fixation type (open versus percutaneous).

Methods: Twenty-four polytrauma patients were retrospectively evaluated. Patients were evaluated according to age, accident dynamic, mechanical ventilation need, blood transfusion need, SAPS II score, type of vertebral injury, time of fixation (within or after 72 h) and type of fixation.

Results: Nine patients underwent percutaneous pedicle screw fixation and 12 open fusion. An early fixation allows better clinical outcome considering ICU stay (13.7 versus 21.71 days), H-LOS (25.8 versus 69.5 days), mechanical ventilation need (7 versus 16.2), blood transfusion need (250 versus 592 cc).

Conclusions: In polytrauma patients an early spine fixation improves clinical outcome. Patients underwent percutaneous screw fixation showed a better outcome compared to open surgery group obtained despite worst clinical conditions.

Fig. 1

a Preoperative CT scan view of patients with a SAPS Score II of 45, an A3.2 amyelic vertebral fracture, a pelvis ring fracture, a complex femoral fracture. b Postoperative X-ray of the same patient showing lumbar percutaneous screw fixation, pelvis ring fixation, femoral external fixator performed in one surgical