Ansar Mohamed Naufel, Hashmi Syed Maroof, Colombo Francesca
Department of Neurosurgery, Royal Preston Hospital, Preston, United Kingdom.
Asian J Neurosurg. 2020 Feb 25;15(1):76-82. doi: 10.4103/ajns.AJNS_236_19. eCollection 2020 Jan-Mar.
Traumatic thoracolumbar fractures are common, and surgical fixation is a well-established treatment option, with the aim to achieve spinal stability and preserve neurological function. Pedicle screw fixation using a minimally invasive spine (MIS) surgical approach has emerged as an alternative approach for the treatment of thoracolumbar fractures. The aim of this study is to collect data regarding epidemiology, management, and outcomes of patients treated with MIS pedicle screw fixation for traumatic thoracolumbar fractures in our neurosurgical department.
This was a retrospective cohort study including all patients who underwent MIS fixation from March 2013 to March 2017.
A total of 125 patients were included, 61 males and 64 females; the mean age was 59 years. The majority of injuries were from falls. In 48 cases, the fracture involved a thoracic vertebra and in 77 cases a lumbar vertebra. More than 10% of the patients presented with a neurological deficit on admission and 75% of those showed postoperative improvement in their neurology. The average length of hospital stay was 14 days. MIS fixation achieved a satisfactory regional sagittal angle (RSA) postoperatively in all patients. The vast majority of patients had no or mild postoperative pain and achieved a good functional outcome.
MIS fixation is a safe surgical option with comparable outcomes to open surgery and a potential reduction in perioperative morbidity. MIS surgery achieves a rapid and significant improvement in pain score, functional outcome, Frankel Grade, and RSA. We expect that MIS fixation will become the predominant technique in the management of traumatic thoracolumbar fractures.
创伤性胸腰椎骨折很常见，手术固定是一种成熟的治疗选择，旨在实现脊柱稳定并保留神经功能。采用微创脊柱（MIS）手术方法进行椎弓根螺钉固定已成为治疗胸腰椎骨折的一种替代方法。本研究的目的是收集有关我院神经外科采用MIS椎弓根螺钉固定治疗创伤性胸腰椎骨折患者的流行病学、治疗方法及治疗结果的数据。
这是一项回顾性队列研究，纳入了2013年3月至2017年3月期间所有接受MIS固定的患者。
共纳入125例患者，其中男性61例，女性64例；平均年龄59岁。大多数损伤由跌倒所致。48例骨折累及胸椎，77例累及腰椎。超过10%的患者入院时存在神经功能缺损，其中75%的患者术后神经功能有所改善。平均住院时间为14天。MIS固定术后所有患者的局部矢状角（RSA）均达到满意效果。绝大多数患者术后无疼痛或仅有轻微疼痛，功能恢复良好。
MIS固定是一种安全的手术选择，其治疗效果与开放手术相当，且围手术期发病率可能降低。MIS手术能使疼痛评分、功能结果、Frankel分级和RSA迅速且显著改善。我们预计MIS固定将成为创伤性胸腰椎骨折治疗的主要技术。
