title: Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: a prospective cohort study of 24 patients with one year of follow-up.
abstract: OBJECTIVE
  Neurologically intact lumbar and thoracolumbar fractures are frequent but their treatment is not codified. The purpose of this study was to evaluate the effectiveness of minimally invasive treatment of such fractures by percutaneous fixation associated with balloon kyphoplasty.
  
  
  METHODS
  Between November 2008 and July 2010, 24 patients were treated. There were 12 men and 12 women, with a mean age of 53 years (range 20-88 years). Fractures were classified as one Magerl lesion type A1, one type A2, 19 A3 (five A31, 10 A32, four A33), and three type B2. The treatment was kyphoplasty of the fractured vertebra followed by percutaneous fixation of the vertebra above and below the fracture. Patient follow-up included an analysis of pain using the visual analogic score, the Oswestry score, and functional X-ray and CT analysis.
  
  
  RESULTS
  Surgery lasted a mean 99 minutes. At the last follow-up, the mean pain was scored at 0.9 and the Oswestry score was 13.2. Reduction of vertebral kyphosis was 8.6° and reduction of the corrected regional angle was 7.1°. The gain in vertebral height was 17%. All pedicle screws were positioned correctly and no neurological, septic, or thromboembolic complications were observed.
  
  
  CONCLUSIONS
  Percutaneous osteosynthesis combined with balloon kyphoplasty is a valuable surgical technique in the treatment of thoracolumbar and lumbar fractures with no neurologic deficit. The clinical results are good and the technique allows the patient to return home earlier without having to wear a corset. The X-ray result scores are very encouraging, with corrections similar to conventional surgery in terms of vertebral height and kyphosis. This technique can be an alternative to conventional open surgery.
  
  
  METHODS
  IV: Prospective observational study.
authors.affiliation: Department of Orthopaedic surgery and traumatology, la Milétrie Teaching Hospital Center, 2, rue de la Milétrie, 86000 Poitiers, France. alexandre.bironneau@cegetel.net
authors.forename: A
authors.initials: A
authors.lastname: Bironneau
authors.forename: C
authors.initials: C
authors.lastname: Bouquet
authors.forename: B
authors.initials: B
authors.lastname: Millet-Barbe
authors.forename: N
authors.initials: N
authors.lastname: Leclercq
authors.forename: P
authors.initials: P
authors.lastname: Pries
authors.forename: L-E
authors.initials: LE
authors.lastname: Gayet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D058498:Kyphoplasty / Q000379:methods*; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009460:Neurologic Examination; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography; D020127:Recovery of Function; D018570:Risk Assessment; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D055815:Young Adult