Skip to main content

Advertisement

Log in

Percutaneous pedicle screw fixation in polytrauma patients

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

The clinical outcome of polytrauma patients underwent spine fixation was analyzed and correlated both to surgical time (early versus delayed) and to fixation type (open versus percutaneous).

Methods

Twenty-four polytrauma patients were retrospectively evaluated. Patients were evaluated according to age, accident dynamic, mechanical ventilation need, blood transfusion need, SAPS II score, type of vertebral injury, time of fixation (within or after 72 h) and type of fixation.

Results

Nine patients underwent percutaneous pedicle screw fixation and 12 open fusion. An early fixation allows better clinical outcome considering ICU stay (13.7 versus 21.71 days), H-LOS (25.8 versus 69.5 days), mechanical ventilation need (7 versus 16.2), blood transfusion need (250 versus 592 cc).

Conclusions

In polytrauma patients an early spine fixation improves clinical outcome. Patients underwent percutaneous screw fixation showed a better outcome compared to open surgery group obtained despite worst clinical conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Seibel R, LaDuca J, Hasset JM et al (1985) Blunt multiple trauma (ISS 36), femur traction, and the pulmonary failure-septic state. Ann Surg 202:283–295

    Article  PubMed  CAS  Google Scholar 

  2. Bone LB, Johnson KD, Weigelt J, Scheinberg R (1989) Early versus delayed stabilization of femural fractures. J Bone Jt Surg Am 71:336–340

    CAS  Google Scholar 

  3. Aebi M, Mohler J, Zach GA, Morscher E (1986) Indication, surgical technique, and results of 100 surgically-treated fractures and fracture-dislocations of the cervical spine. Clin Orthop 203:244–257

    PubMed  Google Scholar 

  4. Kiwerski JE (1993) Early anterior decompression and fusion for crush fractures of cervical vertebrae. Int Orthop 17:166–168

    Article  PubMed  CAS  Google Scholar 

  5. Croce MA, Bee TK, Pritchard E, Miller PR, Fabian TC (2001) Does optimal timing for spine fracture fixation exsist? Ann Surg 233:851–858

    Article  PubMed  CAS  Google Scholar 

  6. Kerwin AJ, Frykberg ER, Schinco MA et al (2007) The effect of early surgical treatment of traumatic spine injuries on patients mortality. J Trauma 63:1308–1313

    Article  PubMed  Google Scholar 

  7. Kerwin AJ, Griffen MM, Tepas JJ, Schinco MA, Dervin T, Frykberg ER (2008) Best practice determination of timing of spinal fracture fixation as defined by analysis of the national trauma data bank. J Trauma 65:824–831

    Article  PubMed  Google Scholar 

  8. Schlegel JB, Yuan H, Fredricksen B (1996) Timing of surgical decompression and fixation of acute spinal fractures. J Ortho Trauma 10:323–330

    Article  CAS  Google Scholar 

  9. Mirza SK, Krengel WF, Chapman JR et al (1999) Early versus delayed surgery for acute cervical spinal cord injury. Clin Orthop Relat Res 359:104–114

    Article  PubMed  Google Scholar 

  10. Schinkel C, Frangen TM, Kmetic A, Andress HJ, Muhr G (2006) German trauma registry. Timing of thoracic spine stabilization trauma patients: impact on clinical course and outcome. J Trauma 61:156–160

    Article  PubMed  Google Scholar 

  11. Kervin AJ, Frykberg ER, Schinco MA, Griffen MM, Murphy T, Tepas JJ (2005) The effect of early spine fixation on non-neurologic outcome. J Trauma 58:15–21

    Article  Google Scholar 

  12. Magerl F, Aebi M, Gertzbein S, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201

    Article  PubMed  CAS  Google Scholar 

  13. Schinkel C, Anastadiasis AP (2008) The timing of spinal stabilization in polytrauma and in patients with spinal cord injury. Curr Op Crit Care 14:685–689

    Article  Google Scholar 

  14. Leucht P, Fischer K, Muhr G, Mueller EJ (2009) Epidemiology of traumatic spine fractures. Injury 40:66–172

    Article  Google Scholar 

  15. Bellabraba C, Fisher C, Chapman JR et al (2010) Does early fracture fixation of thoracolumbar spine fractures decrease morbidity or mortality? Spine 35:S138–S145

    Article  Google Scholar 

  16. Rutges JPHJ, Oner FC, Leenen PH (2007) Timing of thoracic and lumbar fracture fixation in spinal injuries: a systematic review of neurological and clinical outcome. Eur Spine J 16:579–687

    Article  PubMed  Google Scholar 

  17. Albert TJ, Kim DH (2005) Timing of surgical stabilization after cervical and thoracic trauma. J Neurosurg Spine 3:182–190

    Article  PubMed  Google Scholar 

  18. Holdsworth F (1970) Fractures, dislocations, and fractures-dislocations of the spine. J Bone Joint Surg Am 52:1534–1551

    PubMed  CAS  Google Scholar 

  19. Jamienson WRE, Janusz MT, Gudas VM et al (2002) Traumatic rupture of the thoracic aorta: third decade of experience. Am J Surg 183:571–575

    Article  Google Scholar 

  20. Pape HC, Tornetta P 3rd, Tarkin I et al (2009) Timing of fracture fixation in multitrauma patients: the role of early total care and damage control surgery. J Am Acad Orthop Surg 17:541–549

    PubMed  Google Scholar 

  21. Faciszewski T, Winter RB, Lonstein JE et al (1995) The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults: a review of 1,223 procedures. Spine 20:1592–1599

    Article  PubMed  CAS  Google Scholar 

  22. Rechtine GR, Bono PL, Cahill D et al (2001) Postoperative wound infection after instrumentation of thoracic and lumbar fractures. J Orthop Trauma 15:566–569

    Article  PubMed  CAS  Google Scholar 

  23. Rampersaud YR, Annand N, Dekutoski MB (2006) Use of minimally invasive surgical techniques in the management of thoracolumbar trauma. Spine 31:S96–S102

    Article  PubMed  Google Scholar 

  24. Markandaya M, Stein DM, Menaker J (2012) Acute treatment options for spinal cord injury. Curr Treat Options Neurol 14:175–187

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare they have no competing interests.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to L. Proietti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scaramuzzo, L., Tamburrelli, F.C., Piervincenzi, E. et al. Percutaneous pedicle screw fixation in polytrauma patients. Eur Spine J 22 (Suppl 6), 933–938 (2013). https://doi.org/10.1007/s00586-013-3011-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-3011-2

Keywords

Navigation