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KMID : 0388720210280040097
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Journal of Korean Society of Spine Surgery
2021 Volume.28 No. 4 p.97 ~ p.107
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Percutaneous Pedicle Screw Fixation with Vertebral Augmentation Using a Bioengineered Degradable Bone Substitute for Thoracolumbar Fractures
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Kang Min-Seok
You Ki-Han
Chung Hoon-Jae
Hwang Ji-Hyo
Jung Seung-Yeon
Park Hyun-Jin
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Abstract
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Study Design: Retrospective analysis.
Objectives: The study evaluated the technical aspects of percutaneous pedicle screw fixation (PPF) and vertebral augmentation (VA) with bioengineered degradable bone graft substitutes (bd-BGs) using the trans-pedicular approach in a single surgical procedure.
Summary of Literature Review: The effectiveness of PPF with VA using bd-BGs for thoracolumbar fracture has not been established.
Materials and Methods: We enrolled 17 patients diagnosed with acute thoracolumbar fractures who underwent simultaneous PPF and VA using bd-BGs. The short-segment PPF construct included the adjacent vertebra immediately above and below the fractured vertebra, in addition to intermediate screws for the fractured vertebra. The posterior instrumentation was removed at least 9 months after surgery from patients in whom bone union was confirmed by computed tomography. The sagittal Cobb angle and visual analogue scale (VAS) were used to evaluate clinical outcomes.
Results: The mean age of the patients was 62.12±8.18 years. All patients were followed up for at least 12 months after the index surgery, with the mean follow-up period being 14.8±3.32 months. The volume of injected bd-BGs was 3.84±0.19 mL. VAS scores significantly improved 2 weeks after surgery (p<0.001). The sagittal Cobb angle was realigned from an average preoperative value of 26.68±3.93° to 2.86±4.90° post-surgery (p<0.001). bd-BGs leakage was observed in the adjacent superior disc in two patients and an increasing kyphotic angle due to a lower-most instrumented vertebra fracture was observed in one patient. However, there was no significant fixation failure or vertebral re-collapse.
Conclusions: PPF with VA using bd-BGs is technically feasible and may be a simple, effective, and less-invasive treatment for thoracolumbar injuries.
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KEYWORD
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Thoracolumbar fracture, Percutaneous pedicle screw fixation, Vertebral augmentation, Bioengineered degradable bone graft substitute, Calcium-based bioactive ceramics
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