Calleros‑Hernández NA, Valencia‑Martínez G, Hardy‑Pérez AE, Granados‑Agonizante I

Language: Spanish
References: 21
Page: 217-224
PDF size: 213.26 Kb.

ABSTRACT

Introduction: Percutaneous transpedicular fixation techniques are an emerging tool in the treatment of spinal trauma, however, their use is not fully accepted. Objective: Compare results in patients with traumatic vertebral fracture, treated with percutaneous transpedicular fixation surgery versus open transpedicular fixation. Material and methods: From January to December 2016, 15 patients with traumatic vertebral fracture were randomly divided into 2 groups, group A were six treated with percutaneous transpedicular fixation, group B were treated with open technique transpedicular fixation, three patients were eliminated. Transoperative bleeding, postoperative pain with the 24-hour and two-week postoperative visual scale, the six-week Oswestry lumbar pain disability index, and three, six, 12 and 24 months of postoperative control were evaluated. Results: The follow-up was 24 months. Statistically significant differences in transoperative bleeding (p 2.43E-05), EVA on the first day (p ‹ 0.0003), EVA at two weeks (p = 0.01) were reported in the Oswestry lumbar pain disability questionnaire at six weeks (p = 0.0007), three months (p = 0.005), six months (p = 0.005), 12 months (p = 0.01) and 24 months (p = 0.004), no significant differences were observed with respect to operating time (p = 0.12). Discussion: In our work we find that transoperative bleeding, postoperative pain and functional disability are significantly minor in the percutaneous transpedicular fixation group.

REFERENCES

1. Sebaaly A, Rizkallah M, Riouallon G, Wang Z, Moreau PE, Bachour F, et al. Percutaneous fixation of thoracolumbar vertebral fractures. EFORT Open Rev. 2018; 3(11): 604-13.

2. Tian F, Tu L, Gu W, Zhang E, Wang Z, Chu G, et al. Percutaneous versus open pedicle screw instrumentation in treatment of thoracic and lumbar spine fractures. Medicine (Baltimore). 2018; 97(41): e12535.

3. McAnany SJ, Overley SC, Kim JS, Baird EO, Qureshi SA, Anderson PA. Open versus minimally invasive fixation techniques for thoracolumbar trauma: a meta-analysis. Global Spine J. 2016; 6(2): 186-94.

4. Court C, Vincent C. Percutaneous fixation of thoracolumbar fractures: current concepts. Orthop Traumatol Surg Res. 2012; 98(8): 900-9.

5. Lee MJ, Mok J, Patel P. Transforaminal lumbar interbody fusion: traditional open versus minimally invasive techniques. J Am Acad Orthop Surg. 2018; 26(4): 124-31.

6. Skovrlj B, Gilligan J, Cutler HS, Qureshi SA. Minimally invasive procedures on the lumbar spine. World J Clin Cases. 2015; 3(1): 1-9.

7. Matheney T, Sandell L, Foucher K, Lamontagne M, Grodzinsky AJ, Peters CL. Motion analysis, cartilage mechanics, and biology in femoroacetabular impingement: current understanding and areas of future research. J Am Acad Orthop Surg. 2013; 21(Suppl. 1): 27-32.

8. Alander DH, Cui S. Percutaneous pedicle screw stabilization: surgical technique, fracture reduction, and review of current spine trauma applications. J Am Acad Orthop Surg. 2018; 26(7): 231-40.

9. Butt MF, Farooq M, Mir B, Dhar AS, Hussain A, Mumtaz M. Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation. Int Orthop. 2007; 31(2): 259-64.

10. Mohi Eldin MM, Hassan AS. Percutaneous transpedicular fixation: technical tips and pitfalls of sextant and pathfinder systems. Asian Spine J. 2016; 10(1): 111-22.

11. Canale ST, Beaty JH. Campbell cirugía ortopédica. 11a ed. Barcelona: Elsevier. 2010. p. 4385.

12. Tezer M, Erturer RE, Ozturk C, Ozturk I, Kuzgun U. Conservative treatment of fractures of the thoracolumbar spine. Int Orthop. 2005; 29(2): 78-82.

13. Ajay MB, Vijayakumar AV. Comparative study between conventional open spine pedicle screw fixation surgery minimally invasive percutaneous pedicle screw fixation in the management of thoracolumbar spine fracture in adult. Int J Orthop Sci. 2016; 2(4): 154-9.

14. Dhall SS, Wadhwa R, Wang MY, Tien-Smith A, Mummaneni PV. Traumatic thoracolumbar spinal injury: an algorithm for minimally invasive surgical management. Neurosurg Focus. 2014; 37(1): E9.

15. Lyu J, Chen K, Tang Z, Chen Y, Li M, Zhang Q. A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial. Int Orthop. 2016; 40(6): 1233-8.

16. Phan K, Rao PJ, Mobbs RJ. Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: Systematic review and meta-analysis of comparative studies. Clin Neurol Neurosurg. 2015; 135: 85-92.

17. Wu X, Zhang B, Zhang CL, Wu XT, Zhang QH. Efficacy and safety of minimal pedicle screw fixation for thoracolumbar fractures: a meta-analysis. Eur Rev Med Pharmacol Sci. 2018; 22(1 Suppl): 45-52.

18. Chaichana KL, Garza-Ramos RD, Sciubba DM, Gokasian ZL, Baaj AA. Minimally invasive percutaneous pedicle screw fixation for thoracolumbar spine fractures: case report and review of literature. J Trauma Treat. 2012; 1(5): 1-5.

19. Assaker R. Minimal access spinal technologies: state-of-the-art, indications, and techniques. Joint Bone Spine. 2004; 71(6): 459-69.

20. Kim DY, Lee SH, Sang KC, Lee HY. Comparison of multifidus muscle atrophy and trunk extension muscle strength: Percutaneous versus open pedicle screw fixation. Spine (Phila Pa 1976). 2005; 30(1): 123-9.

21. Lee CP, Fu TS, Liu CY, Hung CI. Psychometric evaluation of the Oswestry disability index in patients with chronic low back pain: factor and Mokken analyses. Health Qual Life Outcomes. 2017; 15(1): 192.