Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures

Background Data: The use of pedicle screws for spinal stabilization has become increasingly popular worldwide. Standard open techniques for pedicle screw placement, however, require extensive tissue dissection to expose entry points and to provide lateral to medial orientation for optimal screw tra...

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Autores principales:	Mohamed El-Meshtawy, Khaled Hassan
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2013
Materias:	Thoracolumbar fracture Percutaneous Transpedicle non-canulated screw Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f2db977016b04d05bcbe6c37c783b401
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spelling	oai:doaj.org-article:f2db977016b04d05bcbe6c37c783b4012021-12-02T00:23:39ZSafety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar FracturesDOI:10.21608/ESJ.2013.38202314-89502314-8969https://doaj.org/article/f2db977016b04d05bcbe6c37c783b4012013-07-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_3820.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: The use of pedicle screws for spinal stabilization has become increasingly popular worldwide. Standard open techniques for pedicle screw placement, however, require extensive tissue dissection to expose entry points and to provide lateral to medial orientation for optimal screw trajectory. Minimal invasive techniques (MIT) are widely accepted as being the less aggressive procedure in any kind of surgery. Purpose: The aim of this study was to describe and evaluate a new alternative percutaneous technique using the usual economic non-canulated screws in thoracolumbar fractures. Study Design: A prospective clinical case study. Patients and Methods: Between January 2007 and December 2012, 42 patients (31 males and 11 females) with thoracolumbar fractures were admitted to emergency department of Assiut University Hospital. The mean age of the patients was 37 years (range, 19 to 57). All fractures were classified according to Magerl’s classification. According to American Spinal injury Association (ASIA) Impairment Scale (AIS), all patients were neurologically free (ASIA grade E) preoperatively. Surgery was done within 72 hours after injury. All patients underwent ligamentotaxis through percutaneous posterior approach using non-canulated transpedicle screws. The kyphotic angle was measured according to Cobb method preoperatively, postoperatively, and at latest follow up. Postoperative CT was done for all patients to verify screw position and recording of pedicle violations. Results: The mean operative time was 65 minutes (range, 55 to 120). The mean operative blood loss was 54 ml (range, 35 to 90). The mean preoperative local kyphotic angle (LKA) improved from 12° to -2° postoperatively and 2° at latest follow up. Neurological deterioration occurred in one patient. The average hospital stay was 1.5 days (average, 1 to 3). Misplacement of the screws (3 screws violated the medial wall of the pedicle, 7 violated the lateral wall) was recorded in 10 of 186 screws (5.4%). Conclusion: The percutaneous pedicle screw insertion using non-canulated technique in thoracolumbar spine fracture is safe, economic, and reliable minimal invasive technique. (2013ESA047)Mohamed El-Meshtawy Khaled HassanEgyptian Spine AssociationarticleThoracolumbar fracturePercutaneousTranspediclenon-canulated screwNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 7, Iss 1, Pp 5-12 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Thoracolumbar fracture Percutaneous Transpedicle non-canulated screw Neurology. Diseases of the nervous system RC346-429
spellingShingle	Thoracolumbar fracture Percutaneous Transpedicle non-canulated screw Neurology. Diseases of the nervous system RC346-429 Mohamed El-Meshtawy Khaled Hassan Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures
description	Background Data: The use of pedicle screws for spinal stabilization has become increasingly popular worldwide. Standard open techniques for pedicle screw placement, however, require extensive tissue dissection to expose entry points and to provide lateral to medial orientation for optimal screw trajectory. Minimal invasive techniques (MIT) are widely accepted as being the less aggressive procedure in any kind of surgery. Purpose: The aim of this study was to describe and evaluate a new alternative percutaneous technique using the usual economic non-canulated screws in thoracolumbar fractures. Study Design: A prospective clinical case study. Patients and Methods: Between January 2007 and December 2012, 42 patients (31 males and 11 females) with thoracolumbar fractures were admitted to emergency department of Assiut University Hospital. The mean age of the patients was 37 years (range, 19 to 57). All fractures were classified according to Magerl’s classification. According to American Spinal injury Association (ASIA) Impairment Scale (AIS), all patients were neurologically free (ASIA grade E) preoperatively. Surgery was done within 72 hours after injury. All patients underwent ligamentotaxis through percutaneous posterior approach using non-canulated transpedicle screws. The kyphotic angle was measured according to Cobb method preoperatively, postoperatively, and at latest follow up. Postoperative CT was done for all patients to verify screw position and recording of pedicle violations. Results: The mean operative time was 65 minutes (range, 55 to 120). The mean operative blood loss was 54 ml (range, 35 to 90). The mean preoperative local kyphotic angle (LKA) improved from 12° to -2° postoperatively and 2° at latest follow up. Neurological deterioration occurred in one patient. The average hospital stay was 1.5 days (average, 1 to 3). Misplacement of the screws (3 screws violated the medial wall of the pedicle, 7 violated the lateral wall) was recorded in 10 of 186 screws (5.4%). Conclusion: The percutaneous pedicle screw insertion using non-canulated technique in thoracolumbar spine fracture is safe, economic, and reliable minimal invasive technique. (2013ESA047)
format	article
author	Mohamed El-Meshtawy Khaled Hassan
author_facet	Mohamed El-Meshtawy Khaled Hassan
author_sort	Mohamed El-Meshtawy
title	Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures
title_short	Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures
title_full	Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures
title_fullStr	Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures
title_full_unstemmed	Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures
title_sort	safety and efficacy of percutaneous non-canulated transpedicular screws fixation (tpsf) in the management of thoracolumbar fractures
publisher	Egyptian Spine Association
publishDate	2013
url	https://doaj.org/article/f2db977016b04d05bcbe6c37c783b401
work_keys_str_mv	AT mohamedelmeshtawy safetyandefficacyofpercutaneousnoncanulatedtranspedicularscrewsfixationtpsfinthemanagementofthoracolumbarfractures AT khaledhassan safetyandefficacyofpercutaneousnoncanulatedtranspedicularscrewsfixationtpsfinthemanagementofthoracolumbarfractures
_version_	1718403776518291456

Safety and Efficacy of Percutaneous Non-Canulated Transpedicular Screws Fixation (TPSF) in the Management of Thoracolumbar Fractures

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