title: [Percutaneous treatment of unstable spine fractures - OP video and results from over 300 cases].
abstract: Minimally invasive surgery for vertebral fractures results in less approach-related morbidity, decreased postoperative pain, and rapid mobilisation of patients. Such procedures can be performed even in elderly patients. However, along with the many advantages, minimally invasive procedures are technically demanding, require sophisticated tools, and there is a learning curve for surgeons. Intraoperative visualisation is often possible only radiologically, and implants are generally much more expensive. Using the data from over 300 unstable vertebral fracture cases treated over the past 3.5 years, we have developed a differentiated treatment concept, depending on the age of the patient and the fracture characteristics. Unstable fractures with involvement of the posterior edge are stabilised from posterior, percutaneously with a fixator. In patients under 60 years, monoaxial screws with inserted rods (top loading) are used, with which distraction and restoration of lordosis are also possible. Patients over 60 years are treated percutaneously with a polyaxial sextant system with rods inserted to avoid avulsion of the pedicle screws from the vertebral body. To avoid cutting through the vertebra, the fenestrated screws can be augmented with cement. The operation technique is demonstrated by a video.
authors.affiliation: Unfall-, Hand- und Wiederherstellungschirurgie, Kliniken Sindelfingen, Klinikverbund Südwest.
authors.forename: A
authors.initials: A
authors.lastname: Prokop
authors.affiliation: Unfall-, Hand- und Wiederherstellungschirurgie, Kliniken Sindelfingen, Klinikverbund Südwest.
authors.forename: M
authors.initials: M
authors.lastname: Chmielnicki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging / Q000601:surgery*