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How safe is minimally invasive pedicle screw placement for treatment of thoracolumbar spine fractures?

European Spine Journal volume 26, pages 1515–1524 (2017)Cite this article

Abstract

Study design

Prospective analysis of patients who underwent minimally invasive posterior instrumentation.

Objective

The purpose of this study was to evaluate the safety of minimally invasive pedicle screw placement in patients with unstable thoracic and lumbar spine fractures using the conventional fluoroscopy technique.

Summary of background data

Although wound infection, haematoma, and new neurological deficit due to screw malplacement remain a common source of morbidity, estimates of their rates of occurrence remain relatively limited.

Methods

2052 percutaneous pedicle screws in 433 consecutive patients were evaluated. The accuracy of pedicle screw placement was based on evaluation of axial 3-mm slice computed tomography scans. Morbidity and mortality data were collected prospectively.

Results

A total of 2029 of 2052 screws (99%) had a good or excellent position. 5 screws (0.2%) showed a higher grade violation of the medial pedicle wall. Seven patients (1.8%) needed revision due to screw malposition (3 pat.), surgical site infection, postoperative haematoma, implant failure (2 pat.), and technical difficulties.

Conclusions

Minimally invasive transpedicular instrumentation is an accurate, reliable, and safe procedure to treat thoracic and lumbar spine fractures.

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Author information

Authors and Affiliations

  1. Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany

    Timo Michael Heintel, Stefan Dannigkeit, Annabel Fenwick, Martin Cornelius Jordan, Hendrik Jansen, Fabian Gilbert & Rainer Meffert

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  1. Timo Michael Heintel
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  2. Stefan Dannigkeit
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  3. Annabel Fenwick
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  4. Martin Cornelius Jordan
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  7. Rainer Meffert
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Corresponding author

Correspondence to Timo Michael Heintel.

Ethics declarations

The study was approved by the institutional review board in accordance with the ethical principles originating from the Declaration of Helsinki and in compliance with Good Clinical Practice.

Conflict of interest

None of the authors has any potential conflict of interest.

Informed consent

All patients gave their informed consent.

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Cite this article

Heintel, T.M., Dannigkeit, S., Fenwick, A. et al. How safe is minimally invasive pedicle screw placement for treatment of thoracolumbar spine fractures?. Eur Spine J 26, 1515–1524 (2017). https://doi.org/10.1007/s00586-016-4908-3

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  • DOI: https://doi.org/10.1007/s00586-016-4908-3

Keywords

  • Thoracolumbar spine fractures
  • Complications
  • Infection
  • Instrumentation
  • Minimally invasive