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Updated: Sep 4, 2025

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Trans-Thoracic Extra-Pleural Percutaneous Spinal Fixation-A Technical Note.

Shyam S Krishnan1, Pulak Nigam1, Madabhushi C Vasudevan1

  • 1Post Graduate Institute of Neurological Surgery, Achantha Lakshmipathi Neurosurgical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India.

Neurology India
|July 22, 2022
PubMed
Summary
This summary is machine-generated.

This modified extrapleural thoracotomy technique for thoracic spine fixation uses percutaneous screw placement to reduce incision size and patient morbidity. It effectively treats various spinal pathologies with shorter hospital stays and lower costs.

Keywords:
Extrapleural thoracotomyminimal accessminimal incisionper-cutaneousscrew placement

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Area of Science:

  • Spinal Surgery
  • Thoracic Surgery
  • Minimally Invasive Techniques

Background:

  • Traditional extrapleural approaches for dorsal spine fixation are limited in the number of vertebral levels addressable.
  • Existing methods often require larger incisions and may lead to increased patient morbidity.

Purpose of the Study:

  • To present a modified extrapleural thoracotomy technique for thoracic spine fixation.
  • To evaluate the feasibility of limiting incision size and reducing morbidity in multi-level spinal fixation.

Main Methods:

  • A modified extrapleural thoracotomy approach was employed, limiting incision size to the pathological area.
  • Percutaneous screw placement was utilized through K-wire-defined trajectories.
  • The technique was applied in a cross-sectional analysis of patients undergoing thoracic spine fixation.

Main Results:

  • Eighteen patients with infectious, traumatic, or neoplastic spinal pathologies underwent fixation.
  • Most patients had minimal intensive care unit (ICU) stays (≤1 day) and low pain scores (≤6).
  • The technique successfully addressed multi-level pathologies with reduced incision size.

Conclusions:

  • Combining percutaneous screw placement with extrapleural thoracotomy reduces incision size, tissue damage, and morbidity.
  • This approach offers reduced hospitalization costs and duration without compromising the extent of treatable pathology.
  • The modified technique allows for addressing a greater number of vertebral levels with potentially lower complication rates.