Percutaneous pedicle screw for unstable spine fractures in polytraumatized patients: A report of two cases

Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS). We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.

[1]  O. Schmidt,et al.  Role of early minimal-invasive spine fixation in acute thoracic and lumbar spine trauma , 2007, Indian journal of orthopaedics.

[2]  Bernhard Meyer,et al.  Minimally Invasive Transmuscular Pedicle Screw Fixation of the Thoracic and Lumbar Spine , 2006, Neurosurgery.

[3]  M. Yusof,et al.  Computed Tomographic Morphometry of Thoracic Pedicles: Safety Margin of Transpedicular Screw Fixation in Malaysian Malay Population , 2006, Spine.

[4]  T. Kossmann,et al.  Damage control surgery for spine trauma. , 2004, Injury.

[5]  P. Giannoudis,et al.  The timing of fracture treatment in polytrauma patients: relevance of damage control orthopedic surgery. , 2002, American journal of surgery.

[6]  S. Gumina,et al.  Pedicle instrumentation in the thoracic spine. A morphometric and cadaveric study for placement of screws. , 1999, Spine.

[7]  F. Magerl.  Stabilization of the lower thoracic and lumbar spine with external skeletal fixation. , 1984, Clinical orthopaedics and related research.

[8]  B. Ragel.  Early Versus Late Stabilization of the Spine in the Polytrauma Patient , 2011 .

[9]  C. Chan,et al.  Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation , 2009, European Spine Journal.

[10]  C. Ohaegbulam.  Minimally Invasive Transmuscular Pedicle Screw Fixation of the Thoracic and Lumbar Spine , 2008 .

[11]  C. Heyde,et al.  World Journal of Emergency Surgery Open Access Atls ® and Damage Control in Spine Trauma , 2022 .