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Year : 2017  |  Volume : 4  |  Issue : 2  |  Page : 60-64

Percutaneous posterior fixation: A unique entity to minimize further damage to patient with traumatic spine

1 Resident Doctor, Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat, India
2 Professor, Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat, India

Correspondence Address:
Kaushal R Patel
Resident Doctor, Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat
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Source of Support: None, Conflict of Interest: None

DOI: 10.5005/jp-journals-10039-1129

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Introduction: Percutaneous posterior fixation is a novel and unique modality to fix traumatic spine injury. Conventionally, traumatic spine injury severe enough to consider for fixation is approached by open method. However, this method is disadvantageous as there occurs further trauma to the surrounding soft tissue while approaching spine for fixation. Percutaneous technique, on the contrary, offers stable fixation as conventional method and also offers added advantage of minimal soft tissue damage. Study design: This is an original prospective cohort study of 35 patients having traumatic spine injury operated by percutaneous posterior fixation. Aims and objectives: To compare the midterm results of percutaneous posterior fixation vs conventional (open) posterior fixation and to evaluate the role of percutaneous posterior fixation as damage control surgery (DCS). Materials and methods: This is a prospective cohort study of 35 patients operated at a single center from January 2012 to January 2014 with 2 years of follow-up.
  • Inclusion criteria:
– Patients having traumatic thoracic or lumbar spine injury between level T10 and L3 – Age >18 years – Polytrauma patients having associated spine injury – Patients having normal neurology – Patients having A1, A2, or A3 type of injury according to AO classification
  • Exclusion criteria:
– Patients having neurological deficit – A4 type of injury Results: As observed in our study, traumatic spine injury is more common in middle-aged male patients. Percutaneous fixation provides definitive advantage over conventional method of posterior fixation in terms of decreased intraoperative blood loss, decreased postoperative pain, earlier mobilization of the patients, reduced duration of hospital stay, less complications, and better functional outcome as measured by visual analog scale (VAS) score, Oswestry disability index (ODI) score, and SF-36 score, modified MacNab's criteria. JOSS Postoperatively, all the patients had either excellent or good outcome as measured by MacNab's criteria. Conclusion: Midterm results of percutaneous fixation are equivalent to conventional method with added advantage of reduced risk of infection as observed in our study. Percutaneous fixation has more to it rather than only DCS, however, its role in replacing conventional method requires proper surgeon training, steep learning curve, long-term studies and critical evaluation.

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