title: Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures.
abstract: BACKGROUND
  Treatment of A3 thoraco-lumbar and lumbar spinal fractures nowadays remains a controversial issue. Percutaneous techniques are becoming very popular in the last few years to reduce the approach-related morbidity associated with conventional techniques.
  
  
  OBJECTIVE
  Purpose of the study was to analyze the clinical and radiological outcome of patients who underwent percutaneous posterior fixation without fusion for the treatment of thoraco-lumbar and lumbar A3 fractures.
  
  
  METHODS
  Sixty-three patients, having sustained a single-level thoraco-lumbar fracture, underwent short segment percutaneous instrumentation and were retrospectively analyzed. sagittal index (SI) was calculated in all patients. Clinical and functional outcome were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form General Health Status (SF-36).
  
  
  RESULTS
  Average operative blood loss was 82 mL (50-320). Mean pre-operative SI in the thoraco-lumbar segment was 13.3° decreased to 5.8° in the immediate postoperative with a mean deformity correction of 7.5. Mean pre-operative SI in the lumbar segment was 16.5° decreased to 11.3° in the immediate postoperative with a mean deformity correction of 5.2. Not statistically significant correction loss was registered at 1-year minimum follow-up. Constant clinical conditions improvement in the examined patients was observed.
  
  
  CONCLUSIONS
  Percutaneous pedicle screw fixation for A3 thoraco-lumbar and lumbar spinal fractures is a reliable and safe procedure.
  
  
  METHODS
  Level IV. Retrospective study.
authors.affiliation: Department of Orthopedic Science and Traumatology, Spine Surgery Division, Catholic University Rome, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: proiettil@yahoo.it.
authors.forename: L
authors.initials: L
authors.lastname: Proietti
authors.affiliation: Spine Surgery Division 1, IRCCS Istituto Ortopedico Galeazzi Spa, via Riccardo Galeazzi, 4, 20161 Milano, Italy. Electronic address: scaramuzzolaura@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Scaramuzzo
authors.affiliation: Department of Orthopedic Science and Traumatology, Spine Surgery Division, Catholic University Rome, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: giusepper.schiro@gmail.com.
authors.forename: G R
authors.initials: GR
authors.lastname: Schirò
authors.affiliation: Department of Orthopedic Science and Traumatology, Spine Surgery Division, Catholic University Rome, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: sergiosessa84@yahoo.it.
authors.forename: S
authors.initials: S
authors.lastname: Sessa
authors.affiliation: Department of Orthopedic Science and Traumatology, Spine Surgery Division, Catholic University Rome, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: perlalucente@hotmail.it.
authors.forename: G
authors.initials: G
authors.lastname: D'Aurizio
authors.affiliation: Department of Orthopedic Science and Traumatology, Spine Surgery Division, Catholic University Rome, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: f.tamburrelli@tiscali.it.
authors.forename: F C
authors.initials: FC
authors.lastname: Tamburrelli
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Percutaneous fixation; Sagittal index; Thoraco-lumbar spine fractures; Thoraco-lumbar/lumbar fractures