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Open Access Highly Accessed Research

Outcome after thoracoscopic ventral stabilisation of thoracic and lumbar spine fractures

Roman Pfeifer1*, Miguel Pishnamaz1, Derek Dombroski2, Nicole Heussen3, Hans-Christoph Pape1 and Bernhard Schmidt-Rohlfing1

Author Affiliations

1 Department of Orthopaedic and Trauma Surgery, University of Aachen Medical Center, 30 Pauwels Street, Aachen, 52074, Germany

2 Department of Orthopaedic Surgery, Parkland Health and Hospital Systems, Dallas, USA

3 Department of Medical Statistics, RWTH Aachen University, Aachen, Germany

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Journal of Trauma Management & Outcomes 2012, 6:10  doi:10.1186/1752-2897-6-10

Published: 16 October 2012

Abstract

Background and Purpose

Thoracoscopic-assisted ventral stabilisation for thoracolumbar fractures has been shown to be associated with decreased recovery time and less morbidity when compared with open procedures. However, there are a limited number of studies evaluating late clinical and radiological results after thoracoscopic spinal surgery.

Methods

We performed an analysis of the late outcomes of thoracolumbar fractures after minimally invasive thoracoscopic ventral instrumentation. Between August 2003 and December 2008, 70 patients with thoracolumbar fractures (T5-L2) underwent ventral thoracoscopic stabilisation. Tricortical bone grafts, anterior plating systems (MACS-System), and cage implants were used for stabilisation. Outcomes measured include radiologic images (superior inferior endplate angle), Visual Analogue Scale (VAS), VAS Spine Score, quality of life scores SF-36 and Oswestry Disability Index (ODI).

Results

Forty seven patients (67%, 47 out of 70) were recruited for the follow up evaluation (2.2 ± 1.5 years). Lower VAS Spine scores were calculated in patients with intra- or postoperative complications (44.7 (± 16.7) vs. 65.8 (± 24.5), p=0.0447). There was no difference in outcome between patients treated with bone graft vs. cage implants. Loss of correction was observed in both bone graft and titanium cage groups.

Interpretation

The present study demonstrates diminished long-term quality of life in patients treated with thoracoscopic ventral spine when compared with the outcome of german reference population. In contrast to the other patients, those patients without intra-operative or post-operative complications were associated with improved outcome. The stabilisation method (bone graft versus spinal cage) did not affect the long-term clinical or radiographic results in this series.

Keywords:
Spine; Thoracoscopic surgery; Thoracolumbar fractures; Outcome