J 2020

Percutaneous versus open pedicle screw fixation for treatment of type A thoracolumbar fractures

KOČIŠ, Ján, Martin KELBL, Tomáš KOČIŠ and Tomáš NÁVRAT

Basic information

Original name

Percutaneous versus open pedicle screw fixation for treatment of type A thoracolumbar fractures

Authors

KOČIŠ, Ján (703 Slovakia, guarantor, belonging to the institution), Martin KELBL (203 Czech Republic, belonging to the institution), Tomáš KOČIŠ (703 Slovakia, belonging to the institution) and Tomáš NÁVRAT (203 Czech Republic)

Edition

EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY, Heidelbert, Springer, 2020, 1863-9933

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30221 Critical care medicine and Emergency medicine

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.693

RIV identification code

RIV/00216224:14110/20:00115421

Organization unit

Faculty of Medicine

DOI

UT WoS

000514517700015

Keywords in English

Percutaneous; Thoracolumbar; Spine; Trauma

Tags

Tags

International impact, Reviewed
Změněno: 20/3/2020 10:23, Mgr. Tereza Miškechová

Abstract

V originále

Background The purpose of this study was to evaluate the effectiveness between percutaneous and open pedicle screw fixation without fusion for treating type A3 and A4 thoracolumbar fractures. Traumatic thoracolumbar burst fracture is a common pathology without a consensus on the best treatment approach. Percutaneous pedicle screw fixation (PPSF) systems have been recently introduced in the treatment of spinal fractures to reduce the adverse effects associated with the conventional open approaches, such as iatrogenic muscle denervation and pain. Methods A prospective analysis was made to evaluate consecutive 46 patients with type A3 and A4 thoracolumbar fractures. Patients were divided into a percutaneous pedicle screw fixation group (PPSF) and an open pedicle screw fixation group (OPSF). The mean age of patients in PPSF group (12 men, 11 woman) was 49.9 years and in OPSF group (10 men, 13 women) 52.2 years. For the purpose of evaluation, the radiological assessment of the bisegmental Cobb angle, the loss of correction, the volume of blood loss, operation time, cumulative radiation time and dose were recorded and compared. Results All patients were followed up for 12 months. There were no significant differences between OPSF and PPSF in the Cobb angle preoperative and postoperative angle and the loss of bisegmental correction. In PPSF group, the mean preoperative Cobb angle was 10.9 degrees and improved by 4.5 degrees postoperatively, and in OPSF group the preoperative angle was 12.1 degrees and postoperatively improved by 3.8 degrees. Significant differences between OPSF and PPSF were found in the mean cumulative radiation time, radiation dose and operation time. PPSF group also had a significantly lower perioperative blood loss. Conclusions Both open and percutaneous short-segment pedicle fixation were safe and effective methods to treat thoracolumbar burst fractures. Percutaneous fixation without fusion seems to be suitable for type A3 and A4 fractures.