title: [Percutaneous stabilization of the thoracic and lumbar spine with active intraoperative reduction].
abstract: OBJECTIVE
  Operative treatment of vertebral fractures is focused on stabilization of the spine and decompression of the spinal cord and nerves. In German-speaking countries, it is common to restore the sagittal profile by fracture reduction. The use of percutaneous systems has been limited due to inferior reduction possibilities compared to open systems. The improved reduction options offered by newer percutaneous systems extend their application to highly deformed fractures.
  
  
  METHODS
  Unstable thoracic, lumbar and lumbosacral spine fractures; unacceptable spinal deformities.
  
  
  METHODS
  Need for open decompression or cross-bracing; relative contraindication: obesity or cachexia.
  
  
  METHODS
  3 cm skin incision 1.5 cm lateral to the radiological border of the pedicle. Incision of the fascia and blunt preparation to the facet joints. Guidewire placement via fluoroscopy. Tapping and cannulated screw setting. Insertion of the longitudinal rods and reduction using special reduction tools. Rod fixation with locking caps, wound closure, dressing.
  
  
  METHODS
  Pain-related mobilization, physiotherapy, indication for anterior fusion to be considered.
  
  
  RESULTS
  In 2012, 80 patients (42 female, 38 male) with a mean age of 59.7 years received posterior stabilization (27 open, 53 percutaneous). Intraoperative radiation was significantly higher in the percutaneous group compared with the open group (percutaneous: 212 s; open: 146 s; p < 0.05), while the length of surgical treatment was significantly shorter (percutaneous: 107 min; open: 143 min; p < 0.05). Accuracy of screw positioning and the amount of reduction was similar in both groups. Major complications did not occur.
authors: Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland. mpishnamaz@ukaachen.de.
authors: M
authors: M
authors: Pishnamaz
authors: Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors: P
authors: P
authors: Lichte
authors: Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors: R M
authors: RM
authors: Sellei
authors: Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors: H-C
authors: HC
authors: Pape
authors: Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors: P
authors: P
authors: Kobbe
mesh_terms: D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods; D007593:Joint Instability / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000070799:Open Fracture Reduction / Q000295:instrumentation / Q000379:methods*; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Minimally invasive surgical procedures; Percutaneous instrumentation; Reposition; Spinal cord compression; Vertebral fracture
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