Role of Minimally Invasive Percutaneous Transpedicular Screws in Lumbar Fracture

Background: Pedicle screws for spinal stabilization are used worldwide for degenerative and traumatic spinal diseases. Minimally invasive percutaneous transpedicular lumbar fixation has showed a significant role in minimizing approach-related morbidity while achieving the same result as the traditional invasive approaches. Objectives: This study aimed to determine the outcome of the lumber fixation using percutaneous transpedicular route in lumbar fractures and to evaluate the results of this developing surgical technique. Patients and Methods: This prospective study was conducted on twenty four adult patients with traumatic lumbar fractures. All of them had severe low back pain and were neurologically free. Seventeen were males and seven were females with a mean age of 34.5 years. The mode of trauma was fall from a height in nine patients (33%) and motor car accident in fifteen patients (55%). Fractures were in L1 in eleven patients, L2 in seven patients, L3 in four patients and L4 in two patients .Patients underwent personal history taking and general and neurologic examinations. Each patient was evaluated radiologically by plain x-ray, computerized tomography (CT) scan and magnetic resonance imaging (MRI). These patients were treated by percutaneous pedicle screw fixation. Results: Pain improved significantly in all patients after Surgery (P 0.001).None of our patient had neurological deterioration after surgery. Postoperative radiological investigations showed improving of the preoperative canal compromise. The average pre- operative vertebral body angle improved significantly (P 0.001) immediately after surgery. At the 12 months follow up visit, patients showed continuous improvement of their incapacitating pain. There was persistent improvement of their deformity in comparison to the preoperative imaging studies. Conclusion: Developing minimally invasive approaches to lumbar fusion have participated to minimize approach-related morbidity while achieving the same result as traditional invasive approaches. As the technology continues to evolve, it is expected that minimally invasive spine surgery becomes a prominent part of spinal surgery and that indications for minimally invasive spinal fusion will expand.