Correct positioning of pedicle screws with a percutaneous minimal invasive system in spine trauma

Orthop Traumatol Surg Res. 2014 Jun;100(4):389-93. doi: 10.1016/j.otsr.2014.03.015. Epub 2014 Apr 29.

Abstract

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.

Discussion: 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.

Level of evidence: Level III - Case-control study.

Keywords: Minimally invasive spine fixation; Navigation; Pedicle screws; Spine ORIF.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Screws*
  • Case-Control Studies
  • Child
  • Female
  • Fracture Fixation, Internal / methods*
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Tomography, X-Ray Computed
  • Young Adult