Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Feb 5;21(1):74.
doi: 10.1186/s12891-020-3099-6.

Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures

Christoph J Erichsen  1 , Christoph-Eckhard Heyde  2 , Christoph Josten  2 , Oliver Gonschorek  3 , Stephanie Panzer  4   5 , Christian von Rüden  3   5 , Ulrich J Spiegl  2
Affiliations
Observational Study

Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures

Christoph J Erichsen et al. BMC Musculoskelet Disord. .

Abstract

Background: The purpose of this retrospective cohort study was to compare treatment strategies of two level-one trauma centers regarding clinical and radiological outcomes focusing on non-osteoporotic AOSpine type A3 fractures of the thoracolumbar spine at levels T11 to L2.

Methods: Eighty-seven patients between 18 and 65 years of age that were treated operatively in either of two trauma centers were included. One treatment strategy includes open posterior stabilization whereas the other uses percutaneous posterior stabilization. Both included additional anterior fusion if necessary. Demographic data, McCormack classification, duration of surgery, hospital stay and further parameters were assessed. Owestry Disability Index (ODI), Visual Analog Scale (VAS) and SF-36 were measured for functional outcome. Bisegmental kyphosis angle, reduction loss and sagittal alignment parameters were assessed for radiological outcome. Follow up was at least 24 months.

Results: There was no significant difference regarding our primary functional outcome parameter (ODI) between both groups. Regarding radiological outcome kyphosis angle at time of follow up did not show a significant difference. Reduction loss at time of follow up was moderate in both groups with a significantly lower rate in the percutaneously stabilized group. Surgery time was significantly shorter for posterior stabilization and anterior fusion in the percutaneous group. Time of hospital stay was equal for posterior stabilization but shorter for anterior fusion in the open stabilized group.

Conclusion: Both treatment strategies are safe and effective showing only minor loss of reduction. Clinical relevant differences in functional and radiographic outcome between the two surgical groups could not be demonstrated.

Trial registration: It was conducted according to ICMJE guidelines and has been retrospectively registered with the German Clinical Trials Registry (identification number: DRKS00015693, 07.11.2018).

Keywords: Additional anterior fusion; Percutaneous fixation; Posterior open instrumentation; Sagittal balance; Thoracolumbar fracture.

PubMed Disclaimer

Conflict of interest statement

○CR is a member of the editorial board of this journal

○CJ received royalties from Zimmer, Warsaw, USA; DepuySynthes, West Chester, USA; Medtronic, Minneapolis, USA; Zimmer, Nürnberg, Germany

○CH is an independent consultant for Medtronic, Castel San Pietro, Switzerland

○OG has received payments for lectures for Medtronic GmbH, Meerbusch, Germany und Aesculap AG, Tuttlingen, Germany

○All other authors declare that they have no conflict of interest

Figures

Fig. 1
Fig. 1
Boxplot ODI Score MIS versus OS at follow-up
Fig. 2
Fig. 2
Boxplot Kyphosis angle MIS versus OS at follow-up
Fig. 3
Fig. 3
Boxplot Loss of reduction MIS versus OS at follow-up
See this image and copyright information in PMC

References

    1. Spiegl UJ, Josten C, Devitt BM, Heyde CE. Incomplete burst fractures of the thoracolumbar spine: a review of literature. Eur Spine J. 2017;26(12):3187–3198. doi: 10.1007/s00586-017-5126-3. - DOI - PubMed
    1. Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, et al. AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976) 2013;38(23):2028–2037. doi: 10.1097/BRS.0b013e3182a8a381. - DOI - PubMed
    1. Leucht P, Fischer K, Muhr G, Mueller EJ. Epidemiology of traumatic spine fractures. Inj. 2009;40(2):166–172. doi: 10.1016/j.injury.2008.06.040. - DOI - PubMed
    1. Wood K, Buttermann G, Mehbod A, Garvey T, Jhanjee R, Sechriest V. Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study. J Bone Joint Surg Am. 2003;85-A(5):773–781. doi: 10.2106/00004623-200305000-00001. - DOI - PubMed
    1. Siebenga J, Leferink VJ, Segers MJ, Elzinga MJ, Bakker FC, Haarman HJ, et al. Treatment of traumatic thoracolumbar spine fractures: a multicenter prospective randomized study of operative versus nonsurgical treatment. Spine (Phila Pa 1976) 2006;31(25):2881–2890. doi: 10.1097/01.brs.0000247804.91869.1e. - DOI - PubMed

MeSH terms