Minimally invasive fixation using percutaneous pedicle screws and indirect decompression in unstable thoraco – lumbar fracture
Main Article Content
Abstract
Percutaneous pedicle screws fixation surgery, especially with indirect decompression, is being expanded. In addition to the advantages of minimally invasive surgery, it is still possible to correct the kyphosis, remodel canal stenosis and maintain the anterior vertebral height. At the Department of Neuro-Spinal surgery, Hanoi Medical University Hospital, we applied the percutaneous screw fixation with indirect decompression since January 2021 to evaluate the effectiveness and safety of this technique. Clinical intervention study was applied in 20 patients undergoing percutaneous pedicle screw surgery, in which the indirect manipulation was used in 10 patients. Patients was under general anesthesia, placed in the maximally flexed position, during surgery using the ligamental axis technique and extending fracture vertebral through the skin. Clinical evaluation variables included: spinal kyphosis, canal remodeling, reduction of vertebral body height and the safety of surgery. Mean age was 54,5 years old, average walking time was 2,9 days, clinical recovery rate was 100%. Postoperative kyphotic angle, canal remodeling, and vertebral body collapsed were improved by 10,7%, 11,5% and 18,8%, respectively. In indirect decompression technique, all the indicators significantly improved (p < 0,05). The screw accuracy reaches to 95,7%. Average surgery time was 46 minutes. Average blood loss was 20ml. No neurological complication was noted. Minimally invasive fixation using percutaneous pedicle screws and indirect decompression is highly effective and safe, especially in cases of instability fracture in the thoraco-lumbar area.
Article Details
Keywords
Spinal instability, percutaneous pedicle screws, canal remodelling.
References
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