Abstract
Introduction
Spine fractures in polytrauma patients are relatively common. About one third require surgical treatment. Open surgical stabilization in these patients may increase morbidity and mortality associated with prolonged surgical time, bleeding and hypothermia. Internal fixation with minimally invasive techniques is an alternative for the treatment of vertebral fractures in polytrauma patients, diminishing local and systemic risks associated with open techniques.
Material and Methods
Polytrauma patients with unstable thoracolumbar spine fractures, treated by percutaneous pedicle fixation techniques, between June 2013 and March 2015.
Results
5 patients. Injury mechanisms involved: height fall, height fall associated with extensive skin burn of dorsal region and motor vehicle accidents. Fracture level where between T6 to L5. According to AOSpine trauma classification: 3 B2, 1 B3 and 1 A4. Surgery was performed on an average of 5 days since trauma. 2 levels were fixated in 2 patients, 3 in other 2 patients and one patient had a lumbopelvic fixation. The average of intraoperative bleeding was 70 ml and of operative time was 100 minutes. No patient had postoperative local infection or complications from surgery. No patients required revision surgery or deferred anterior column stabilization surgery. All patients had at least 6 months follow-up.
Conclusion
Percutaneous pedicle fixation is an alternative for treatment of unstable vertebral fractures in polytrauma patients with poor general or local conditions. The results in this series are encouraging in the sense of accomplishing stabilization without increasing the morbidity and mortality associated to basal conditions.