Percutaneous Osteosynthesis of Thoraco Lumbar Fractures: Is Post CT-Scann Mandatory?

Abstract

Introduction: Percutaneous fixation of traumatic thoraco-lumbar spine fractures represents an innovative technique. The objective of our work was to evaluate the pedicle screw placement of this technique using a post-operative CT-scan. Methods: We conducted a retrospective and descriptive study including 30 cases over a period of 2.5 years. We evaluated postoperative CT-scan parameters by studying the accuracy of pedicle screw placement using the Rao classification. Results: The mean age was 44 years, the sex ratio was 1.3 with 17 male and 13 female. The lesion was located at the thoraco-lumbar hinge in 73.34% and in 70% it was classified as A3 with a mean posterior wall recession of 36.33%. A total of 186 pedicle screws were inserted. According to the classification of Rao 38.7% of the screws were misplaced, of which 11.29% were non-minor perforations (grade 2 and 3). Conclusion: Postoperative CT to check the precise placement of the pedicle screws in asymptomatic patients has not shown any benefit: 11.29 % were major misplaced without any clinical repercussion. Therefore, a postoperative CT scan must be critically discussed and should be reserved for symptomatic patients.