Minimally Invasive Transpedicular Screw Fixation for Thoracolumbar Fractures- A Retrospective Analysis in a Basic Neurosurgery Unit

摘要

Thoracic and lumbar fractures are among the most common type of traumatic spine fractures. With advanced surgical technique and instrumentation the use of minimally invasive pedicle screw fixation for thoracolumbar fractures has increased. Minimally invasive spine procedures avoid excessive muscle dissection and decreases trauma to tissues during surgery.Aim: To study the outcome with minimally invasive spine surgery for thoracolumbar fractures.Materials and Methods: This study was designed as a retrospective descriptive study. All patients with thoracic and lumbar fractures who had undergone minimally invasive percutaneous pedicle screw fixations from June 2016 to May 2019, in the Department of Neurosurgery were included. Cases requiring laminectomy were excluded. A total of 25 patients were included in this study. Mean blood loss, operative time, hospital stay, postoperative pain and complications were assessed. Data was entered in excel sheet and statistically analysed using charts and graphs.Results: Nineteen males (76%) and six females (24) were included in this study. Mean age of the study population was 41.45 years. Mean blood loss was 125 mL and no patient required blood transfusion. Average duration of the procedure was 104±34.9 minutes. Improved pain score was noted during postoperative period. No patient developed Cerebro Spinal Fluid (CSF) leak, new onset neurological deficits and bowel or bladder involvement during the postoperative period.Conclusion: Minimally invasive spine fixation surgery is safe and less destructive procedure which is fast and is associated with minimal morbidity. Percutaneous techniques are associated with less blood loss, shorter hospital stay and improved perioperative pain scores. From the present study it was noticed that there was an increased risk for radiation associated with minimally invasive pedicle screw fixation.