Abstract

Minimal Invasive Surgery for spinal trauma: Outcome of percutaneous vertebral augmentation with percutaneous pedicle screw fixation. H. El-Maghraby, S.M. Joshi, A. Ahad, H. Ellamushi, J. Yeh Department of Neurosurgery, University Hospital Coventry & Warwick and The Royal London Hospital, , United Kingdom Objective: The aim of this study was to prospectively evaluate the long-term outcomes following percutaneous vertebral augmentation and pedicle screw fixation of vertebral body compression fractures due to trauma. Methods: Symptomatic patients with vertebral body compression fractures due to trauma were assessed with plain radiograph, computed tomography and magnetic resonance imaging with short tau inversion recovery (STIR) sequences. Of these, 38 patients (24 males, age range 19-48 years) underwent percutaneous vertebral augmentation with percutaneous pedicle screws fixation from August 2003 to January 2009. A total of 44 (38 single, 3 multiple levels) T11, T12 and L1 represent 90% of all the vertebral levels treated. Outcomes were the visual analogue scale (VAS) for pain, radiographic evaluations of height restoration, kyphotic and wedge angle corrections, and Oswestry Disability Index (ODI). These were measured post-operatively on day 1, week 1, months 1, 3, 6 and years 1, 2 and 3. Follow-up was from 2 months to 4.2 years. Results: The mean reduction of VAS was 6.1 +/- 2... Mean anterior height correction was 12.0% with kyphotic angle correction of 5.5 degrees and wedge correction of 5.7 degrees. Mean reduction of ODI improved was 49 points +/- 4.5. One patient had asymptomatic cement extravasation, one had worsening of vertebral collapse. There was no procedure-related mortality. Conclusion: This minimally invasive procedure can provide long-term beneficial pain relief and improvement in functional outcome associated with radiological stabilisation of vertebral body height.