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. 2015:2015:639542.
doi: 10.1155/2015/639542. Epub 2015 Nov 16.

Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

S Pesenti  1 , T Graillon  1 , N Mansouri  1 , P Rakotozanani  1 , B Blondel  1 , S Fuentes  1
Affiliations

Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

S Pesenti et al. Biomed Res Int. 2015.

Abstract

Introduction: While thoracolumbar fractures are common lesions, no strong consensus is available at the moment.

Objectives: The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures.

Methods: 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS). All evaluations were done preoperatively and at 1-year follow-up.

Results: Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus -1° and -9° P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05). At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up.

Conclusion: Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis) is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

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Figures

Figure 1
Figure 1
Measurement of the ratio between the anterior and the posterior wall of the collapsed vertebra.
Figure 2
Figure 2
Sagittal pre- (a) and postoperative (b) CT-scan showing a vertebral fracture with a lesion of the superior disc and results after posterior percutaneous osteosynthesis and partial corpectomy.
Figure 3
Figure 3
Sagittal postoperative CT-scan showing results after posterior percutaneous osteosynthesis and anterior body graft using an expandable body prosthesis.
See this image and copyright information in PMC

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