Evaluation of percutaneous surgery in the treatment of thoracolumbar fractures. Preliminary results of a prospective study on 65 patients.
BACKGROUND
We conducted a prospective, single-center, continuous study of patients operated for fractures urelated to osteoporosis at the thoracolumbar junction level using percutaneous techniques. The aim of this study was to investigate the clinical and radiological outcomes of percutaneous techniques for these indications.


METHODS
This study included patients who underwent standalone balloon kyphoplasty surgery or combined with percutaneous posterior osteosynthesis in cases of associated distraction. The fractures were classified according to the Magerl classification. The patients were evaluated clinically (visual analog scale [VAS], the Oswestry Disability Index, and autonomy) and radiologically (vertebral kyphosis and height variations of the vertebral body) for 12 months.


RESULTS
Sixty-five patients were included. The mean age at the time of the surgery was 45.4 years (range, 19-72 years). The main indications were A.1 fractures of L1. We noted 22% cement leakages, none having a clinical impact. In the overall series, the VAS at the lesional level improved from 5.5 (range, 3-8) preoperatively to 0.6 (range, 1-3) at 12 months. In all, 95% of the workers resumed their occupation. Traumatic kyphosis improved from 13.3° (range, 5-23°) before the surgery to 8.3° (range, 1-20°).


CONCLUSIONS
The complication rate was low. The radiological results are comparable to those reported in the literature for other series with percutaneous surgery. Only the loss of the correction observed in the group undergoing standalone kyphoplasty with calcium phosphate cement led us to propose another type of treatment for these indications. This study must be continued over the long term to detect the appearance of discopathy related to cement leakage and to answer questions as to how cement evolves.


METHODS
III, prospective study with low statistical power.
Department of Orthopaedic Surgery and Traumatology, La Milétrie Teaching Hospital, Poitiers, France. s.teyssedou@gmail.com
S
S
Teyssédou
M
M
Saget
R
R
Prébet
N
N
Leclercq
T
T
Vendeuvre
P
P
Pries
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult