Comparison between percutaneous and traditional fixation of lumbar spine fracture: Intraoperative radiation exposure levels and outcomes
| Autor: | B. Padovani, R. de Dompsure, G. Bruneton, F. de Peretti, T. Boli, M Challali, A. Fuchs, Nicolas Amoretti, N. Bronsard |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Radioprotection Percutaneous Adolescent medicine.medical_treatment Kyphosis Radiation Dosage Intraoperative Period Young Adult Patient satisfaction medicine Humans Minimally Invasive Surgical Procedures Internal fixation Orthopedic Procedures Orthopedics and Sports Medicine Thoracolumbar spine fracture Reduction (orthopedic surgery) Aged Fixation (histology) Pain Postoperative Percutaneous spine surgery Lumbar Vertebrae business.industry Retrospective cohort study Length of Stay Middle Aged medicine.disease Surgery Minimally invasive spine surgery Patient Satisfaction Open spine surgery Radiological weapon Spinal Fractures Female Radiology business |
| Zdroj: | Orthopaedics & Traumatology: Surgery & Research. 99(2):162-168 |
| ISSN: | 1877-0568 |
| DOI: | 10.1016/j.otsr.2012.12.012 |
| Popis: | Summary Objective To compare radiation exposure doses and clinical and radiological outcomes between percutaneous pedicular screwing (closed reduction internal fixation [CRIF]) and classical open reduction internal fixation (ORIF) in lumbar spine fracture without neurologic deficit. Materials and methods Sixty patients (mean age, 42.5 years) were divided into two treatment groups: (Percutaneous) CRIF versus (traditional) ORIF. Screw position and anatomic vertebral reconstruction were checked on routine control X-ray and postoperative CT scan. Study parameters comprised: surgery time, radiation exposure time, radiation dose level for X-ray (DAP) and for CT (DLP),blood loss, length of hospital stay and postoperative pain (VAS). Results At a mean 25.5 months’ follow-up,there were no significant inter-group differences on the epidemiological parameters: age, gender, fracture level, fracture type on the Magerl classification, preoperative local vertebral kyphosis angle, or fracture-to-surgery interval. Effective radiation dose was 3-fold higher in CRIF than in ORIF, but 6-fold lower than for the postoperative CT scan. Postoperative pain on VAS was significantly lower after CRIF, allowing earlier gait resumption and return to work and daily activity. There were no significant differences in length of hospital stay, patient satisfaction, screw malpositioning or postoperative or end-of-follow-up kyphosis angle. Conclusion Percutaneous surgery provided clinical and radiological outcomes strictly comparable to those of open surgery, but with a higher effective radiation exposure dose, including for the medical team and especially for the surgeon. This higher exposure dose, however, is to be relativized by comparison to that of the postoperative CT scan, which involved a much higher exposure dose for the patient. Level of evidence Level IV. Retrospective study. |
| Databáze: | OpenAIRE |
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