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Case series
Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series
  1. Henri Salle1,
  2. Alexandre Meynard1,
  3. Emilie Auditeau2,
  4. Clément Gantois1,
  5. Aymeric Rouchaud3,4,
  6. Charbel Mounayer3,
  7. Patrick Faure1,
  8. François Caire1
  1. 1 Neurosurgery, CHU Limoges, Limoges, France
  2. 2 Epidemiology and Statistical Analysis, CHU Limoges, Limoges, France
  3. 3 Interventional Neuroradiology, CHU Limoges, Limoges, France
  4. 4 University of Limoges, CNRS, XLIM, UMR 7252, Limoges, France
  1. Correspondence to Dr Henri Salle, Neurosurgery, CHU Limoges, Limoges, France; henrisalle1{at}gmail.com

Abstract

Background There is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).

Objective To assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.

Methods We retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.

Results A total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.

Conclusions This is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.

  • balloon
  • spinal cord
  • spine
  • trauma

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Footnotes

  • Contributors HS, PF, CM and FC: study conception, design, data acquisition, interpretation, and drafting the manuscript and critically revising it. AM, EA, CG, AR: contributed to data acquisition and critical revisions of the manuscript. All authors approved the final manuscript and are accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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