脊椎ジャーナル

Minimally Invasive Stabilization for Thoracolumbar Fractures

Abstract

Yasin Sarıkafa, Hikmet Demirkol, Olgun Peker and Suat Erol Celik

Minimally invasive approaches are becoming increasingly widespread due to numerous potential advantages (smaller scars, diminished local pain, reduced blood loss, reduced postoperative wound pain, shorter hospital stays) in spinal surgery. Nowadays, minimally invasive stabilization is more frequently used to treat some thoracolumbar fractures. The aim of this study is to explore the feasibility and effect of minimally invasive stabilization for the treatment of unstable thoracolumbar fractures without neurological impairment. From October 2011 to February 2012, 20 patients with thoracolumbar fracture who were treated with minimally invasive stabilization were included in this study. Charts and operative notes were analyzed for epidemiological data, injured segments, operative time, bleeding volume, mobilization interval, complications and lengths of stay. All patients were successfully managed with minimally invasive stabilization. There were 14 males and 6 females with a mean age of 33.75 years ranging from 18 to 59 years. The L1 vertebra was the most injured vertebral level (35%), followed by T12 and L2. Mechanisms of injury included falling from a height (12 patients) and traffic accidents (8 patients). The average operative time was 72 minutes (range 60 to 122 min). The average intraoperative blood loss was 80 ml (range 50 to 270 ml). Minimally invasive instrumentation of the spine reduces intraoperative blood loss, soft tissue trauma, operative time, infection rates and hospital stay. Future developments in minimally invasive technology will lead to improved results with increased indications and applications.