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Surgical fixation of pathologic and traumatic spinal fractures using single position surgery technique in lateral decubitus position

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Abstract

Study design

Retrospective Case Series.

Objectives

This study aims to determine complications, readmission, and revision surgery rates in patients undergoing single position surgery (SPS) for surgical treatment of traumatic and pathologic thoracolumbar fractures.

Methods

A multi-center review of patients who underwent SPS in the lateral decubitus position (LSPS) for surgical management of traumatic or pathologic thoracolumbar fractures between January 2016 and May 2020 was conducted. Operative time, estimated blood loss (EBL), intraoperative complications, postoperative complications, readmissions, and revision surgeries were collected.

Results

A total of 12 patients with a mean age of 45 years (66.67% male) were included. The majority of patients underwent operative treatment for acute thoracolumbar trauma (66.67%) with a mean injury severity score (ISS) of 16.71. Mean operative time was 175.5 min, mean EBL of 816.67 cc. Five patients experienced a complication, two of which required revision surgery for additional decompression during the initial admission. All ambulatory patients were mobilized on postoperative day 1. The mean hospital length of stay (LOS) was 9.67 days.

Conclusion

The results of this case series supports LSPS as a feasible alternative to the traditional combined anterior–posterior approach for surgical treatment of pathologic and thoracolumbar fractures. These results are similar to reductions in operative time, EBL, and LOS seen in the elective spine literature with LSPS.

Level of Evidence

IV.

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Acknowledgements

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Funding

No external financial support was received for this work.

Author information

Authors and Affiliations

  1. Atlantic Neurosurgical and Spine Specialists, Wilmington, NC, USA

    J. Alex Thomas

  2. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Joshua Olexa

  3. Division of Spine Surgery, Department of Orthopaedic Surgery, University of Maryland Medical Center, 110 S. Paca Street, 6th Floor, Ste. 300, Baltimore, MD, 21201, USA

    Alexandra E. Thomson, Ivan Ye, Vincent Miseo, Kendall Buraimoh, Daniel L. Cavanaugh, Eugene Y. Koh & Steven C. Ludwig

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  1. Alexandra E. Thomson
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Contributions

Alexandra E. Thomson, J. Alex Thomas, MD, Ivan Ye, Vincent Miseo, Joshua Olexa, Daniel L. Cavanaugh, Eugene Y. Koh, Kendall Buraimoh, and Steven C. Ludwig made substantial contributions to the study concept or design; or the collection, analysis, or data interpretation. All authors contributed to drafting, revising, and critical review of the work. All authors approved the final version for publication and agree to accountable for the accuracy and integrity of the work.

Corresponding author

Correspondence to Steven C. Ludwig.

Ethics declarations

Ethics Statement

IRB approval was obtained by the University of Maryland IRB (Protocol: HP-00097218) due to the retrospective nature of the study specific consent requirement was waived by the IRB. This study was conducted in accordance with the 1964 Helsinki Declaration, its amendments, and other equivalent ethical standards.

Consent to participate

Institutional IRB deemed this study was exempt from a written participant consent requirement due to the retrospective nature of the study.

Conflicts of interest

The authors report the following disclosures: consultant for and royalties from NuVasive; stock in TrackX Technologies; consultant for Biomet; board member for the American Board of Orthopaedic Surgery, the American Orthopaedic Association, the Cervical Spine Research Society, and the Society for Minimally Invasive Spine Surgery; consultant for DePuy Synthes and K2M/Stryker; board member for Nuvasive; receives payment for lectures and travel accommodations from DePuy Synthes and K2M/Stryker; payment for patents and royalties from DePuy Synthes; stock in Innovative Surgical Designs and the American Society for Investigative Pathology; research support from AO Spine North America Spine Fellowship support and AOA Omega Grant; is a board member of Maryland Development Corporation; royalties from Thieme, Quality Medical Publishers; editorial board member of Journal of Spinal Disorders and Techniques, The Spine Journal, and Contemporary Spine Surgery.

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The views expressed in the submitted article are our own and not an official position of the institution.

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The data generated and analyzed during the current study is available upon reasonable request to the corresponding author.

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Thomson, A.E., Thomas, J.A., Ye, I. et al. Surgical fixation of pathologic and traumatic spinal fractures using single position surgery technique in lateral decubitus position. Eur Spine J 31, 2212–2219 (2022). https://doi.org/10.1007/s00586-022-07128-8

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  • DOI: https://doi.org/10.1007/s00586-022-07128-8

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