title: CT- and fluoroscopy-guided percutaneous screw fixation of a "carrot-stick" spinal fracture in an elderly man with ankylosing spondylitis.
abstract: We present a case of percutaneous fixation of a "carrot-stick" spinal fracture in an elderly patient with ankylosing spondylitis (AS). A surgical stabilization was not possible in this 83-year-old man with comorbidities. Under local anesthesia, percutaneous screw fixation of a transdiscal shear fracture at the level T10-T11 was performed using computed tomography (CT) and fluoroscopy guidance. Two 4.0-mm Asnis III cannulated screws were placed to fix facet joints using transfacet pedicle pathway. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 10, preoperatively, to 1 after the procedure. Radiographic fusion was observed at a 3-month post-procedural CT scan. CT- and fluoroscopy-guided percutaneous screw fixation of spinal fractures could potentially be an alternative to surgery in elderly AS patients with poor performance status.
authors.affiliation: Department of Radiology, Centre Hospitalo-Universitaire de Nice, Hôpital Archet 2 151, route Saint-Antoine de Ginestière, 06200, Nice, France, huwart.laurent@wanadoo.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Huwart
authors.forename: Nicolas
authors.initials: N
authors.lastname: Amoretti
mesh_terms: D000369:Aged, 80 and over; D001863:Bone Screws; D005471:Fluoroscopy / Q000379:methods; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome