Combination of percutaneous osteosynthesis and vertebroplasty of thoracolumbar split fractures under CT and fluoroscopy guidance: a new technique

Cardiovasc Intervent Radiol. 2014 Oct;37(5):1363-8. doi: 10.1007/s00270-014-0849-6. Epub 2014 Jan 31.

Abstract

Objectives: The purpose of our study was to evaluate the technical feasibility of the combination involving percutaneous screw fixation and vertebroplasty in split fractures of thoracolumbar spine.

Methods: Institutional review board approval and informed consent were obtained. Ten consecutive adult patients who had posttraumatic vertebral split fractures (Magerl A2) were prospectively treated by an interventional radiologist under computed tomography and fluoroscopy guidance. Using a bilateral route under local anesthesia, one 4.0-mm cannulated screw was placed on one side to fix the fracture, and on the other side, vertebroplasty was performed. Follow-up ranging from 12 to 24 months was assessed using visual analog scale (VAS) and Oswestry disability index (ODI) RESULTS: Combined procedures were performed on thoracic and lumbar vertebrae, creating both osteosynthesis and cement bridge between the displaced fragment and the rest of the vertebral body. Mean VAS measurements ± standard deviation (SD) decreased from 7.5 ± 1.5 preoperatively to 3.2 ± 1.9 at 1 day, 2.1 ± 1.2 at 1 month, and 1.9 ± 1.4 at the last examination (P < 0.001). Mean ODI scores ± SD decreased from 65.3 ± 16.2, preoperatively, to 16.1 ± 5.0 at the final examination (P < 0.001).

Conclusions: This study suggests that type A2 vertebral fractures could be successfully stabilized by the combination of percutaneous osteosynthesis and vertebroplasty.

MeSH terms

  • Adult
  • Aged
  • Bone Cements / therapeutic use
  • Bone Screws*
  • Feasibility Studies
  • Female
  • Fluoroscopy / methods
  • Fracture Fixation, Internal / methods*
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Radiography, Interventional / methods*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / surgery
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Vertebroplasty / methods*
  • Young Adult

Substances

  • Bone Cements