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Unilateral biportal endoscopic technique combined with percutaneous transpedicular screw fixation for thoracolumbar burst fractures with neurological symptoms: technical note and preliminary report – Lumbar Spinal Stenosis

This article discusses a new surgical technique for treating thoracolumbar fractures with neurological symptoms. The study aimed to achieve satisfactory fracture reduction, nerve decompression, and stable spinal alignment while minimizing iatrogenic trauma. The researchers used percutaneous transpedicular screw distraction to partially reduce the fractured vertebrae, followed by nerve decompression and reduction of residual bone fragments using the unilateral biportal endoscopic (UBE) technique. The results showed successful surgeries in all six patients, with good reduction of bone fragments and normal neurological symptoms at the last follow-up. The UBE technique combined with percutaneous transpedicular screw fixation was found to effectively restore nerve function, stabilize spinal alignment, and protect bone-ligament tissue

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative sugical centre in UK

Published article

CONCLUSION: The UBE technique combined with percutaneous transpedicular screw fixation in the treatment of thoracolumbar fractures with neurological symptoms can effectively achieve the reduction of displaced bone fragments, improve damaged nerve function, stabilize spinal alignment, and protect the integrity of bone-ligament tissue.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Orthop Surg Res. 2023 Aug 8;18(1):584. doi: 10.1186/s13018-023-04063-2.ABSTRACTBACKGROUND: Previous studies on thoracolumbar fractures with neurological symptoms have focused on how to achieve satisfactory fracture reduction, adequate nerve decompression, and stable spinal alignment. With the development of the minimally invasive spine surgery technique, achieving satisfactory treatment results and reducing iatrogenic trauma at the same time,

J Orthop Surg Res. 2023 Aug 8;18(1):584. doi: 10.1186/s13018-023-04063-2.

ABSTRACT

BACKGROUND: Previous studies on thoracolumbar fractures with neurological symptoms have focused on how to achieve satisfactory fracture reduction, adequate nerve decompression, and stable spinal alignment. With the development of the minimally invasive spine surgery technique, achieving satisfactory treatment results and reducing iatrogenic trauma at the same time has become a new goal of spinal surgery. This research used percutaneous transpedicular screw distraction to partially reduce the fractured vertebrae, followed by completing nerve decompression and reducing residual displacement bone fragments with the assistance of the unilateral biportal endoscopic (UBE) technique to achieve full protection of bone-ligament tissue and obtain good clinical efficacy.

METHODS: Guide wires were safely inserted into the fractured vertebra and adjacent upper and lower vertebra under the surveillance of anteroposterior and lateral X-ray fluoroscopy. Transpedicular screws were implanted via guide wires on the side with mild neurological deficits or bone fragment compression (the opposite side of the endoscopic operation). A titanium rod was installed and moderately distracted to reduce the fractured vertebra. Then, under the guidance of the endoscopic view, the laminectomy and ligamentum flavum resection were completed according to the position of the protruding bone fragment into the spinal canal, and the compressed dural sac or nerve root was fully exposed and decompressed. An L-shaped replacer was used to reduce residual bone fragments. The ipsilateral transpedicular screws and rod were installed and adjusted to match the contralateral side. The drainage tube was indwelled, and the incision was closed. The preoperative and postoperative images of the patients were evaluated, and the recovery of neurological symptoms was observed.

RESULTS: Surgery was successfully completed on all six patients, and no intraoperative conversion to open surgery was performed. Postoperative images showed good reduction of the protruding bone fragment and good placement of all screws. At the last follow-up, the neurological symptoms of all patients returned to normal.

CONCLUSION: The UBE technique combined with percutaneous transpedicular screw fixation in the treatment of thoracolumbar fractures with neurological symptoms can effectively achieve the reduction of displaced bone fragments, improve damaged nerve function, stabilize spinal alignment, and protect the integrity of bone-ligament tissue.

PMID:37553701 | PMC:PMC10408116 | DOI:10.1186/s13018-023-04063-2

The London Spine Unit : innovative sugical centre in UK

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Unilateral biportal endoscopic technique combined with percutaneous transpedicular screw fixation for thoracolumbar burst fractures with neurological symptoms: technical note and preliminary report

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J Orthop Surg Res. 2023 Aug 8;18(1):584. doi: 10.1186/s13018-023-04063-2.ABSTRACTBACKGROUND: Previous studies on thoracolumbar fractures with neurological symptoms have focused on how to achieve satisfactory fracture reduction, adequate nerve decompression, and stable spinal alignment. With the development of the minimally invasive spine surgery technique, achieving satisfactory treatment results and reducing iatrogenic trauma at the same time

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