Abstract
Introduction
Currently, we have multiple options for surgical treatment of thoracolumbar fractures. Among these, percutaneous pedicle fixation raises several advantages, particularly in terms of reduced soft tissue injury and the ability to recover motion segments in cases with consolidation potential as type B1 and some type B2 fractures. Our objective is to analyze the radiological results of treatment of these fractures by percutaneous pedicle fixation and the preservation of motion segments after implant removal.
Patients and Methods
Prospective, observational, and descriptive study of radiological follow-up case series of patients with thoracolumbar spine fractures with bony failure of the posterior tension band and without neurological involvement treated by percutaneous pedicle fixation surgery. Radiological results were evaluated by measurement of preoperative regional kyphosis, correction achieved, correction preservation, bone healing, and recovery of mobile segments post removal of fixation. For statistical analysis, the Student t test for paired samples was used.
Results
A total of 13 patients, 12 men and 1 woman, with a mean age of 40 years. Overall, five type B1 and eight type B2 fractures between T9 and L2. Fixation for two levels was performed in all of them. An average correction of 8 degrees (p = 0.0036), reaching normal levels in 10 patients was achieved. At 6 months' follow-up, loss of correction was observed in all patients. The average loss was 7 degrees (p = 0.0021), a regional kyphosis remained within the normal range in eight patients. Consolidation was observed at 8 months' follow-up in all the patients. Material removal was performed in seven patients. Of these, five had a preservation of mobility within normal ranges. No intra- or postoperative complications occurred. Overall, two patients had partial loosening of the fixation system.
Conclusion
Percutaneous pedicle fixation presents an effective alternative in treating thoracolumbar fractures with the bony failure of posterior tension band with consolidation potential. The results in our experience are comparable to those described for both minimally invasive and traditional techniques. The possibility of removal of material for preserving mobile levels presents an important advantage compared with techniques involving fusion.