An Innovative Minimally Invasive Delta Fixation for Thoracolumbar Fracture With Diffuse Idiopathic Skeletal...

Area of Science:

• Orthopedics
• Spine Surgery
• Geriatric Medicine

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) causes ligamentous ossification, leading to unstable spinal fractures in elderly individuals.
• Conventional pedicle screw fixation for DISH fractures faces challenges like screw loosening and implant failure due to osteoporotic bone.

Observation:

• Transdiscal screw fixation has emerged as a robust anchoring method for osteoporotic spines.
• Triangular fixation, combining transdiscal and downward screws, shows promise for long posterior spinal fusion.

Findings:

• A minimally invasive delta fixation technique was successfully employed to treat an L1 fracture in an 86-year-old male with DISH.
• This novel approach addresses the instability and fixation challenges associated with DISH spinal fractures in the elderly.

Implications:

• The delta fixation technique represents a promising advancement in managing complex spinal fractures in patients with DISH.
• This minimally invasive strategy may improve outcomes and reduce complications compared to traditional fixation methods.