Percutaneous minimally invasive instrumentation for traumatic thoracic and lumbar fractures : A prospective analysis

Published online: Jun 27 2012

Antonio KRÜGER, Katharina RAMMLER, Ewgeni ZIRING, Ralph ZETTL, Steffen RUCHHOLTZ, Thomas M. FRANGEN

From the University Hospital Giessen and Marburg, Location Marburg, Germany


Open posterior instrumentation is still the standard procedure for unstable traumatic thoracic and lumbar fractures. There is a general tendency towards minimally invasive approaches in various surgical disciplines. The Sextant™ II Rod Insertion system is one of these. The authors prospectively studied this system in 51 patients with thoracic and lumbar fractures, between October 2007 and January 2011. Most fractures (31/51) were situated at the lumbar level. In 7 older patients the technique was combined with kyphoplasty and/or cement augmentation of the pedicle screws. The median operative time was 61 minutes (range : 26-130). The median fluoroscopy time was 132 seconds (range : 24-414). Most pedicle screws were correctly placed : 197 out of 204 screws. All fractures showed bony union after 6 weeks, but the multiaxial pedicle screws were not able to conserve the slight correction obtained peroperatively via positioning and longitudinal traction. Percutaneous minimally invasive stabilization of the spine needs further improvement.