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Chin M, Camacho JE, Ye IB, Bruckner JJ, Thomson AE, Jauregui JJ, Buraimoh K, Cavanaugh DL, Koh EY, Gelb DE, Ludwig SC. Postoperative outcomes of minimally invasive pedicle screw fixation for treatment of unstable pathologic neoplastic fractures. J Orthop 2022; 30:72-76. [PMID: 35241892 PMCID: PMC8866487 DOI: 10.1016/j.jor.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/14/2022] [Indexed: 10/19/2022] Open
Abstract
STUDY DESIGN Retrospective Case Series. OBJECTIVES Minimally invasive techniques have emerged as a useful tool in the treatment of neoplastic spine pathology due to decrease in surgical morbidity and earlier adjuvant treatment. The objective of this study was to analyze outcomes and complications in a cohort of unstable, symptomatic pathologic fractures treated with percutaneous pedicle screw fixation (PPSF). METHODS A retrospective review was performed on consecutive patients with spinal stabilization for unstable pathologic neoplastic fractures between 2007 and 2017. Patients who underwent PPSF through a minimally invasive approach were included. Surgical indications included intractable pain, mechanical instability, and neurologic compromise with radiologic visualization of the lesion. RESULTS 20 patients with mean Tomita Score of 6.3 ± 2.1 points [95% CI, 5.3-7.2] were treated with constructs that spanned a mean of 4.7 ± 1.4 [95% CI, 4.0-5.3] instrumented levels. 10 (50%) patients were augmented with vertebroplasty. Majority of patients (65%) had no complications during their hospital stay and were discharged home (60%). Four patients received reoperation: two extracavitary corpectomies, one pathologic fracture at a different level, and one adjacent segment disease. CONCLUSION Minimally invasive PPSF is a safe and effective option when treating unstable neoplastic fractures and may be a viable alternative to the traditional open approach in select cases. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Matthew Chin
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Jael E. Camacho
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Ivan B. Ye
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Jacob J. Bruckner
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Alexandra E. Thomson
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Julio J. Jauregui
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Kendall Buraimoh
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Daniel L. Cavanaugh
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Eugene Y. Koh
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Daniel E. Gelb
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA
| | - Steven C. Ludwig
- Spine Surgery Division, Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca Street, 6FL Ste. 300, Baltimore, MD, 21201, USA,Corresponding author. Division of Spine Surgery University of Maryland Department of Orthopaedics, 110 S. Paca Street 6th floor, Ste. 300, Baltimore, MD, 21201, USA.
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