RT Journal Article
SR Electronic
T1 Open vs Percutaneous Pedicle Instrumentation for Kyphosis Correction in Traumatic Thoracic and Thoracolumbar Spine Injuries
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 1009
OP 1015
DO 10.14444/8329
VO 16
IS 6
A1 Jael E. Camacho
A1 Ryan D. Gentry
A1 Ivan B. Ye
A1 Alexandra E. Thomson
A1 Jacob J. Bruckner
A1 Justin E. Kung
A1 Daniel L. Cavanaugh
A1 Eugene Y. Koh
A1 Daniel E. Gelb
A1 Steven C. Ludwig
YR 2022
UL http://ijssurgery.com//content/16/6/1009.abstract
AB Objectives Percutaneous pedicle instrumentation (PPI) has been used for the treatment of thoracic and thoracolumbar (TL) trauma. However, the ability of PPI to correct significant post-traumatic kyphosis requires further investigation. The objective of this study is to compare the amount of kyphosis correction achieved by PPI vs the traditional open posterior approach in patients presenting with significant kyphotic deformity following traumatic thoracic and TL spine injuries.Methods Following Institutional Review Board approval, patients who underwent surgery for thoracic (T1-T9) or TL (T10-L2) fractures with at least 15° of focal kyphosis in a 5-year period were included in this study. Patients were separated into 2 cohorts based on surgical technique: traditional open posterior approach and minimally invasive PPI. Kyphosis correction was measured using Cobb angle 1 vertebrae above and 1 below the level of injury on sagittal preoperative computed tomography image, immediate and follow-up postoperative upright lateral radiographs. Initial degree of correction and loss of correction at the final follow-up were compared.Results Of 91 patients included, 65 (71%) underwent open surgery and 26 (29%) underwent PPI. Open patients had 11° (95% CI, 9°–13°) of immediate correction compared with 11° (95% CI, 6°–15°) for PPI (P = 0.81). Follow-up data were available for 70 patients with a median of 105.5 days. Both groups had 1° (95% CI, 0°–2°) of loss of correction at follow-up (P = 0.82). Regardless of surgical technique, obesity (>30 kg/m2) and AO type-A compression fractures had significantly less correction. For each unit of body mass index, there was a 0.75° decrease in correction achieved (P < 0.0001). Other factors did not influence the degree of correction.Conclusions PPI techniques provide equivalent postoperative angular correction and maintenance of correction compared with open surgery in thoracic and TL trauma patients.Clinical Relevance This study provides evidence for spine surgeons to utilize either technique for treating significant traumatic kyphotic deformity.Level of Evidence Therapeutic 3.