Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracolumbar burst fracture

Abstract

Introduction: To evaluate the feasibility, efficacy and safety of minimally invasive pedicle screw fixation (MIPS) combined with percutaneous vertebroplasty (PVP) using calcium phosphate for the treatment of thoracolumbar burst fracture without neurologic deficits.

Methods: Between September 2011 and April 2013, a total of thirty-seven patients with a mean age of 50.73 years (range 40-63 years), who suffered from thoracic or lumbar burst fracture without neurologic deficits underwent the procedure of MIPS combined with PVP using calcium phosphate. The preoperative and postoperative pain assessment were evaluated using Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA). The Cobb angles and central and anterior columns height were measured on the lateral radiographs before surgery and immediately, 1 month, 3 months, 6 months, 1 year and 2 years after surgery.

Results: The patients were followed up for an average of 27.54 ± 2.47 months. The mean VAS significantly decreased from 9 (range 6-10) before surgery 2 (range 1-3) immediately after surgery and 1 (range 0-2) at 2-year follow-up. The Cobb angle was 22.58 ± 1.70° before surgery and 4.11 ± 1.41° immediately after surgery and 5.06 ± 1.11° at 2-year follow-up. The central and anterior vertebral body height decreased from 44.10 ± 7.0% and 49.76 ± 6.43% before surgery to 80.09 ± 4.05% and 93.31 ± 1.87% immediately after surgery, respectively. No significant changes in vertebral body height restoration were observed during 2 years follow-up after surgery. In addition, there were no instrumentation failure and complications in all patients.

Conclusions: Our study indicated that MIPS combined with PVP using calcium phosphate is a good choice for the treatment of thoracolumbar burst fracture without neurologic deficits.

Keywords: Minimally invasive spinal surgery; Pedicle screw fixation; Thoracolumbar burst fracture; Vertebroplasty.