Minimally invasive fixation techniques for thoracolumbar fractures: comparison between percutaneous pedicle screw with intermediate screw (PPSIS) and percutaneous pedicle screw with kyphoplasty (PPSK)

  • Gaetano CarusoEmail author
  • Enrica Lombardi
  • Mattia Andreotti
  • Vincenzo Lorusso
  • Alessandro Gildone
  • Sara Padovani
  • Leo Massari
Original Article • SPINE - MINIMAL SURGERY



To assess and compare the efficacy of two minimally invasive techniques (percutaneous pedicle screw with intermediate screw vs. percutaneous pedicle screw with kyphoplasty) for spinal fracture fixation by comparing the segmental kyphosis and vertebral kyphosis angles after trauma before surgery, after surgery, and at 4-month and 12-month follow-up.


Data from 49 patients without neurological deficit treated by either percutaneous pedicle screw with intermediate screw or percutaneous pedicle screw with kyphoplasty were retrospectively analysed. The segmental kyphosis and vertebral kyphosis angles over time were calculated and correlated with the type of procedure, AO classification, lumbar or thoracic site and the age and sex of the patients.


After surgery, both techniques were found to be efficacious means of bringing about a significant correction of the segmental kyphosis angle (p = 0.002) and a just significant correction of the vertebral kyphosis angle (p = 0.06), although less effectively in thoracic fractures (p = 0.004). At follow-up, the vertebral kyphosis angle was stable in both groups, while there was a significant loss of segmental kyphosis angle stability in the percutaneous pedicle screw with kyphoplasty group at 1 year (p = 0.004); fractured thoracic vertebrae maintained a greater vertebral kyphosis angle (p = 0.06) and segmental kyphosis angle (p < 0.001), than the lumbar.


At 1 year after surgery, the use of intermediate screws in fractured vertebrae seemed to maintain a more efficacious correction with respect to kyphoplasty, although thoracic fracture sites appear to be associated with greater post-traumatic segmental kyphosis and lesser stability in the long term after both percutaneous surgical techniques.


Thoracolumbar fractures Minimally invasive fixation Percutaneous screws Intermediate screw Kyphoplasty Vertebral kyphosis Segmental kyphosis 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Biomedical and Specialty Surgical SciencesAzienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of FerraraFerraraItaly
  2. 2.Orthopaedic and Traumatology DepartmentAzienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of FerraraFerraraItaly

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