Combination of percutaneous osteosynthesis and vertebroplasty of thoracolumbar split fractures under CT and fluoroscopy guidance: a new technique.
OBJECTIVE
The purpose of our study was to evaluate the technical feasibility of the combination involving percutaneous screw fixation and vertebroplasty in split fractures of thoracolumbar spine.


METHODS
Institutional review board approval and informed consent were obtained. Ten consecutive adult patients who had posttraumatic vertebral split fractures (Magerl A2) were prospectively treated by an interventional radiologist under computed tomography and fluoroscopy guidance. Using a bilateral route under local anesthesia, one 4.0-mm cannulated screw was placed on one side to fix the fracture, and on the other side, vertebroplasty was performed. Follow-up ranging from 12 to 24 months was assessed using visual analog scale (VAS) and Oswestry disability index (ODI) RESULTS: Combined procedures were performed on thoracic and lumbar vertebrae, creating both osteosynthesis and cement bridge between the displaced fragment and the rest of the vertebral body. Mean VAS measurements ± standard deviation (SD) decreased from 7.5 ± 1.5 preoperatively to 3.2 ± 1.9 at 1 day, 2.1 ± 1.2 at 1 month, and 1.9 ± 1.4 at the last examination (P < 0.001). Mean ODI scores ± SD decreased from 65.3 ± 16.2, preoperatively, to 16.1 ± 5.0 at the final examination (P < 0.001).


CONCLUSIONS
This study suggests that type A2 vertebral fractures could be successfully stabilized by the combination of percutaneous osteosynthesis and vertebroplasty.
Department of Radiology, Centre Hospitalo-Universitaire de Nice, Hôpital Archet 2, 151, route Saint-Antoine de Ginestière, 06200, Nice, France.
Nicolas
N
Amoretti
Laurent
L
Huwart
D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use; D001863:Bone Screws; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D055815:Young Adult
D001843:Bone Cements