European Spine Journal

, Volume 21, Issue 5, pp 850–854 | Cite as

Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures

  • Nimrod Rahamimov
  • Hani Mulla
  • Adi Shani
  • Shay Freiman
Original Article



Internal fixation of unstable thoracolumbar spine fractures requires correction of the lacking anterior column support. This usually entails insertion of a vertebral body replacement strut through an anterior approach, or a long posterior construct spanning at least two vertebrae above and two vertebrae below the fracture. Posterior short-segment pedicle instrumentation (SSPI)—one vertebra above and below—is suitable for approximately 40% of fractures, but not for all.


A total of 52 patients with unstable thoracolumbar burst fractures meeting our inclusion criteria were instrumented using a novel approach, combining percutaneous SSPI, pedicle screw augmentation with polymethyl methacrylate (PMMA) and fractured vertebra kyphoplasty. We retrospectively reviewed patient and fracture data, operative results and 1 year radiographic follow-up postoperatively in 40 of the patients. We reviewed operative complications of all 52 patients.


Most fractures were AO/Magerl type A3.1, A3.2 and A3.3. They were instrumented within 72 h and ambulated without additional external bracing. Operative time averaged 2 h and blood loss was less than 50 cc in most cases. Complications were mostly related to PMMA leakage. On average, 3.3° (0–13) of correction was lost after 3 months, but remained constant afterward.


Percutaneous augmented short-segment pedicle instrumentation of unstable thoracolumbar fractures can be done with short operative times, minimal blood loss and a low complication rate. The radiographical results at 1 year are equal to anterior stabilization and are better than other posterior-only techniques.


Spine Fracture Kyphoplasty Pedicle Trauma Percutaneous instrumentation 



Research funds have been received during the preparation of this work from the following: The Western Galilee Hospital, Israel Spine Society, Medtronic Israel, Tzamal-Jakobsohn Ltd., Israel.

Conflict of interest


Supplementary material

586_2011_2106_MOESM1_ESM.xlsx (18 kb)
Supplementary material 1 (XLSX 18 kb)


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Nimrod Rahamimov
    • 1
  • Hani Mulla
    • 1
  • Adi Shani
    • 2
  • Shay Freiman
    • 1
  1. 1.Spine Surgery UnitWestern Galilee HospitalNahariaIsrael
  2. 2.Department of Surgery BWestern Galilee HospitalNahariaIsrael

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