Minimally invasive management of thoraco-lumbar fractures: combined percutaneous fixation and balloon kyphoplasty.
METHODS
Retrospective review of prospectively collected data.


BACKGROUND
There is no consensus regarding the ideal treatment of thoraco-lumbar spine fractures without neurological compromise. Many surgical techniques have been described but none has proved its definite superiority. The main drawback of these procedures is directly related to the morbidity of the approach. As minimally invasive fixation combined with balloon kyphoplasty for treatment of thoraco-lumbar fractures is gaining popularity, its efficacy has yet to be established.


OBJECTIVE
The purpose of this study is to report operative data, clinical and radiological outcomes of patients undergoing minimally invasive management of thoraco-lumbar fracture at our institutions.


METHODS
Forty-one patients underwent percutaneous kyphoplasty and stabilization for treatment of single-level fracture of the thoracic or lumbar spine. All patients were neurologically intact. There were 20 males and 21 females with an average age of 50 years.


RESULTS
The mean follow-up was 15 months (3-90 months). The mean operative time was 102 minutes (range 35-240 minutes) and the mean blood loss was <100mL. VAS was significantly improved from 6.7 to 0.7 at last follow-up. Vertebral kyphosis decreased by 16° to 7.8° postoperatively (P<0.001). Local kyphosis and percentage of collapse were also significantly improved from 8° to 5.6° and from 35% to 16% at last follow-up. Fifteen leaks have been identified, three of which were posterior; all remained asymptomatic. No patient worsened his or her neurological condition postoperatively.


CONCLUSIONS
Percutaneous stabilization plus balloon kyphoplasty seems to be a safe and effective technique to manage thoraco-lumbar fractures without neurological impairment.
Department of Neurosurgery, Lille University Hospital, rue Emile-Laine, 59037 Lille, France. fahed.zairi@gmail.com
F
F
Zairi
C
C
Court
P
P
Tropiano
Y P
YP
Charles
J
J
Tonetti
S
S
Fuentes
S
S
Litrico
H
H
Deramond
J
J
Beaurain
P
P
Orcel
J
J
Delecrin
M
M
Aebi
R
R
Assaker
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D058498:Kyphoplasty / Q000379:methods; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D056888:Patient Positioning; D061214:Patient Safety; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*