Percutaneous screw instrumentation in the treatment of thoracic and lumbar fractures in children

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-02-21 DOI:10.1016/j.neuchi.2025.101649

Mélodie-Anne Karnoub, Matthieu Vinchon, Malick Sagenly, Richard Assaker

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引用次数: 0

Abstract

Purpose

Managing thoracolumbar fractures implies stabilization of the level involved and restoration of global sagittal balance. These objectives are especially challenging in children’s growing spine, even more as they occur very rarely.

Methods

We reviewed all cases of children aged under 18, operated in Lille University Hospital from 2005 to 2021. We included all children treated by percutaneous screw fixation for thoracic or lumbar vertebral fracture. Clinical data before and after surgery, surgical early and late course, sagittal balance were key elements to our study.

Results

21 patients were included, mean age was 16 (13–18), 52% were male. In Aospine classification, our cohort was composed by A4 fractures (9 patients), A3 fractures (4 patients), A2 fractures (3 patients), B1 fracture (3 patients), B2 fractures (1 patient) and B3 fractures (1 patient). 14 patients had short-segment fixations. Surgical length was average 86 min, blood loss was meaningless (average 50 mL), hospital stay was average 9 days, because of association with other traumatic pathologies. No complication was recorded. VA score was always diminished after surgery and no chronic pain was recorded. For all patients, an improvement of vertebral kyphosis and sagittal balance was demonstrated. One year follow-up revealed no case of pseudoarthrosis, no late kyphosis, even after material removal.

Conclusion

Percutaneous screw fixation is a rapid, safe and relevant technique, that should always be considered first, while discussing surgery in children or adolescents for non neurologic thoracolumbar fracture.

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目的胸腰椎骨折的治疗需要稳定相关水平并恢复整体矢状面平衡。我们回顾了 2005 年至 2021 年在里尔大学医院接受手术的所有 18 岁以下儿童病例。我们纳入了所有接受经皮螺钉固定治疗的胸椎或腰椎骨折患儿。手术前后的临床数据、手术早期和晚期疗程、矢状面平衡是我们研究的关键要素。结果 21 名患者被纳入研究，平均年龄为 16 岁（13-18 岁），52% 为男性。按照 Aospine 分类，我们的队列由 A4 骨折（9 例）、A3 骨折（4 例）、A2 骨折（3 例）、B1 骨折（3 例）、B2 骨折（1 例）和 B3 骨折（1 例）组成。14名患者进行了短段固定。手术时间平均为 86 分钟，失血量很少（平均为 50 毫升），平均住院时间为 9 天，因为与其他创伤性病症有关。无并发症记录。术后 VA 评分总是降低，没有慢性疼痛的记录。所有患者的椎体后凸和矢状平衡均得到改善。结论经皮螺钉固定术是一种快速、安全且实用的技术，在讨论儿童或青少年非神经性胸腰椎骨折的手术治疗时，应首先考虑该技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.