Correct positioning of pedicle screws with a percutaneous minimal invasive system in spine trauma.
BACKGROUND
When performing minimally invasive spine surgery in trauma patients, a short operation time and a perfect positioning of pedicle screws are demanded. In this study, we show that a Minimally Invasive Pedicle Screw System allows both.


METHODS
One hundred and twenty-one patients (131 fractures) with fractures between Th 3 and L 5 were treated. The most common fracture type was A3. We treated 52 females and 69 men with a mean age of 56.7 years. In 72% of the cases, the procedure was performed by two experienced spine surgeons. Postoperatively, all patients were examined using a CT-scan. In 61 patients, an anterior stabilization was additionally performed in 33 patients, vertebroplasty or cyphoplasty was performed. Fifteen patients underwent laminectomy.


RESULTS
No patient postoperatively developed any additional neurological compromise. In total, 682 screws were placed. In the postoperative CT-scan, we found 16 screws (2.2%) in suboptimal position, 8 with medial and 8 with lateral deviation.


CONCLUSIONS
With the Minimally Invasive Pedicle Screw System used in this study, spinal fractures can be treated in a short operation time with percutaneous stabilization and a correct positioning of the pedicle screws in almost 98%. In our study, no screw was so much malpositioned that revision surgery would have been necessary.


METHODS
Level III - Case-control study.
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany.
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Tinelli
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany.
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Matschke
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany.
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M
Adams
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany.
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Grützner
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany.
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Münzberg
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University Hospital, Ludwig Guttmann Strasse 13, 67071 Ludwigshafen, Germany; Department for Septic Surgery, BG Trauma Center Ludwigshafen, Germany. Electronic address: arnold@drsuda.com.
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Suda
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
Minimally invasive spine fixation; Navigation; Pedicle screws; Spine ORIF