Complications in minimally invasive percutaneous fixation of thoracic and lumbar spine fractures

Michele Cappuccio, Luca Amendola, Stefania Paderni, Giuseppe Bosco, Giovanbattista Scimeca, Loris Mirabile, Alessandro Gasbarrini, Federico De Iure

Research output: Contribution to journalArticle

Abstract

Minimally invasive stabilization of thoracic and lumbar fractures without neurologic involvement is becoming a more frequent alternative to open fusion and conservative treatment. The authors analyzed the complication rate and limits of this technique in a consecutive series of 99 patients (127 thoracolumbar vertebral fractures) who underwent this technique between May 2005 and November 2009. Eighty-three patients had only spine injuries, whereas 16 had polytrauma injuries (mean Injury Severity Score, 25.2). In these 16 patients, percutaneous fixation was performed as a damage control procedure. The most frequent construct was monosegmental: 1 level above and 1 level below the fractured vertebra. In the remaining 21 patients, multilevel construction was performed for multiple injuries. Complications were analyzed according to the period of onset (intra- and postoperative) and the severity (major and minor). Twelve (12%) complications were recorded: 4 (4%) were intraoperative, 6 (6%) were early postoperative, and 2 (2%) were late postoperative; 4 (4%) were minor and 8 (8%) were major. Mean follow-up was 52 months (range; 36-90 months). All patients except 1 were considered healed after 6-month follow-up. The failed patient had an initial kyphosis greater than 20°, and a posterior open reduction and fusion would have been more appropriate. Minimally invasive stabilization of selected spine injuries is a safe technique with a low complication rate. The main goal of this approach is a fast recovery time, so any complication leading to an extended length of stay should be considered severe. An adequate learning curve is important to minimize complications.

Original languageEnglish
JournalOrthopedics
Volume36
Issue number6
DOIs
Publication statusPublished - Jun 2013

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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    Cappuccio, M., Amendola, L., Paderni, S., Bosco, G., Scimeca, G., Mirabile, L., Gasbarrini, A., & De Iure, F. (2013). Complications in minimally invasive percutaneous fixation of thoracic and lumbar spine fractures. Orthopedics, 36(6). https://doi.org/10.3928/01477447-20130523-16