Traumatic thoracolumbar spinal injury: an algorithm for minimally invasive surgical management

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Trauma Management

Background:

• Minimally invasive spinal (MIS) surgery is increasingly used for thoracolumbar junction trauma.
• Current literature lacks a standardized algorithm for planning MIS treatment in these cases.
• This study addresses the need for a structured approach to MIS for thoracolumbar trauma.

Purpose of the Study:

• To develop a treatment algorithm for thoracolumbar trauma utilizing minimally invasive spinal surgery techniques.
• To provide a framework for selecting appropriate MIS approaches based on injury characteristics.

Main Methods:

• Comprehensive review of existing literature on MIS treatment for thoracolumbar trauma.
• Development of a novel MIS trauma treatment algorithm.
• Integration of concepts from the Thoracolumbar Injury Classification System (TLICS) into the algorithm.

Main Results:

• The study presents case examples demonstrating the application of the developed MIS trauma treatment algorithm.
• Techniques employed include mini-open lateral approaches and minimally invasive posterior decompression with fusion.
• The algorithm facilitates the successful surgical management of thoracolumbar trauma patients.

Conclusions:

• Minimally invasive spinal surgery is a viable and safe option for select thoracolumbar burst fractures.
• Percutaneous nonfusion techniques have limited application, primarily in patients prone to autofusion, such as those with ankylosing spondylitis.
• The proposed algorithm aids in optimizing MIS treatment planning for thoracolumbar trauma.