Percutaneous Screw Distraction for Anatomic Restoration: Case Series

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Trauma Surgery

Background:

• Traumatic thoracolumbar burst fractures present challenges for surgical correction, particularly kyphosis.
• Traditional percutaneous pedicle screw fixation with distraction has limitations in achieving optimal anatomic restoration.
• Fixed-angle screws offer potential for improved vertebral height restoration and spinal canal decompression.

Purpose of the Study:

• To evaluate the radiographic outcomes of distraction across fixed-angle percutaneous screw systems.
• To assess the effectiveness of this technique in restoring vertebral height and reducing spinal canal compromise.
• To examine immediate and long-term radiographic results following surgical intervention.

Main Methods:

• A case series of 22 patients with traumatic thoracolumbar fractures undergoing percutaneous pedicle screw fixation.
• Radiographic measurements (cross-sectional area, vertebral body index, Cobb angle) were taken pre-distraction, post-distraction, and at long-term follow-up.
• Statistical analysis included paired t-tests, Student's t-tests, Mann-Whitney U tests, and chi-squared tests.

Main Results:

• Significant improvements were observed in injured-level cross-sectional canal area (28.6% increase) and vertebral body index (18.8° mean change).
• The mean bisegmental Cobb angle improved by 6.2°, and vertebral body compression decreased by 22.4%.
• Surgical experience correlated with improved outcomes, with superior cross-sectional area and compression ratios achieved with the final technique.

Conclusions:

• Distraction across fixed-angle percutaneous screw instrumentation effectively stabilizes thoracolumbar burst fractures.
• The technique demonstrates success in correcting deformity and decompressing the spinal canal.
• Further research is needed to compare percutaneous instrumentation with open fusion for thoracolumbar trauma outcomes.