Surgical fixation of pathologic and traumatic spinal fractures using single position surgery technique in lateral decubitus position

Eur Spine J. 2022 Sep;31(9):2212-2219. doi: 10.1007/s00586-022-07128-8. Epub 2022 Feb 5.

Abstract

Study design: Retrospective Case Series.

Objectives: This study aims to determine complications, readmission, and revision surgery rates in patients undergoing single position surgery (SPS) for surgical treatment of traumatic and pathologic thoracolumbar fractures.

Methods: A multi-center review of patients who underwent SPS in the lateral decubitus position (LSPS) for surgical management of traumatic or pathologic thoracolumbar fractures between January 2016 and May 2020 was conducted. Operative time, estimated blood loss (EBL), intraoperative complications, postoperative complications, readmissions, and revision surgeries were collected.

Results: A total of 12 patients with a mean age of 45 years (66.67% male) were included. The majority of patients underwent operative treatment for acute thoracolumbar trauma (66.67%) with a mean injury severity score (ISS) of 16.71. Mean operative time was 175.5 min, mean EBL of 816.67 cc. Five patients experienced a complication, two of which required revision surgery for additional decompression during the initial admission. All ambulatory patients were mobilized on postoperative day 1. The mean hospital length of stay (LOS) was 9.67 days.

Conclusion: The results of this case series supports LSPS as a feasible alternative to the traditional combined anterior-posterior approach for surgical treatment of pathologic and thoracolumbar fractures. These results are similar to reductions in operative time, EBL, and LOS seen in the elective spine literature with LSPS.

Level of evidence: IV.

Keywords: Combined anterior–posterior fixation; Single position surgery (SPS); Single position surgery in lateral decubitus position (LSPS); Thoracolumbar trauma; Unstable burst fracture.

MeSH terms

  • Decompression, Surgical / methods
  • Female
  • Fracture Fixation, Internal / methods
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Fractures* / diagnostic imaging
  • Spinal Fractures* / pathology
  • Spinal Fractures* / surgery
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / surgery
  • Treatment Outcome