The evaluation of early results of combined percutaneous pedicle screw fixation and kyphoplasty for the management of thoraco-lumbar burst fractures

Between October 2008 and April 2009, 9 patients with thoracolumbar burst fractures underwent percutaneous short-segment pedicle screw fixation and augmentation kyphoplasty with calcium phosphate cement. All patients were selected according to the type of fracture (unstable type A3 fractures based on the Magerl classification) the absence of neurological signs and an intact posterior longitudinal ligament on the pre-operative MRI scan. Patient demographics, co-morbidities and complications were recorded. The main endpoints included Cobb angle correction, vertebral body height restoration and the length of hospital stay.

There were 3 male and 6 female patients with an average age of 43.6 years. The average follow-up was 2.4 months. The mean kyphotic angulation improved from 18.40 pre-operatively to 6, 80 post-operatively. The loss of vertebral body height improved from a mean of 38.7 % pre-operatively to 12.1 % post-operatively. The average duration of surgery was 40 minutes with insignificant blood loss. There were no post-operative complications. The average length of hospital stay was 3.2 days.

The combination of percutaneous short-segment pedicle screw fixation supplemented by balloon kypho-plasty for the management of thoracolumbar burst fractures with no neurological deficit offers correction of the normal thoracolumbar anatomy as well as augmentation of the anterior load-bearing column, using a minimally invasive technique. The early results are promising