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Minimally invasive spine surgery in the treatment of thoracolumbar and lumbar spine trauma

机译：微创脊柱外科手术治疗胸腰椎和腰椎创伤

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摘要

Thoracolumbar and lumbar trauma account for the majority of traumatic spinal injuries. The mainstay of current treatments is still nonoperative therapy with bracing. Classic treatment algorithms reserved absolute surgical intervention for spinal trauma patients with neurological compromise or instability. Relative indications included incapacitating pain and obesity/body habitus making brace therapy ineffective. In the past decade, minimally invasive surgical (MIS) techniques for spine surgery have been increasingly used for degenerative conditions. These same minimally invasive techniques have seen increased use in trauma patients. The goal of minimally invasive surgery is to decrease surgical morbidity through decreased soft-tissue dissection while providing the same structural stability afforded by classic open techniques. These minimally invasive techniques involve percutaneous posterior pedicle fixation, vertebral body augmentation, and utilization of endoscopic and thoracoscopic techniques. While MIS techniques are somewhat in their infancy, an increasing number of studies are reporting good clinical and radiographic outcomes with these MIS techniques. However, the literature is still lacking high-quality evidence comparing these newer techniques to classic open treatments. This article reviews the relevant literature regarding minimally invasive spine surgery in the treatment of thoracolumbar and lumbar trauma.
机译：胸腰椎和腰椎外伤占脊柱外伤的大部分。目前治疗的主要手段仍然是非手术治疗。经典的治疗算法为患有神经功能受损或不稳定的脊柱外伤患者保留了绝对的手术干预措施。相对适应症包括无行为能力的疼痛和肥胖症/身体习性，导致支架治疗无效。在过去的十年中，用于脊柱手术的微创外科（MIS）技术已越来越多地用于退化性疾病。这些相同的微创技术已在创伤患者中得到越来越多的使用。微创外科手术的目标是通过减少软组织剥离来降低手术发病率，同时提供经典开放技术所提供的相同结构稳定性。这些微创技术涉及经皮后路椎弓根固定，椎体增大以及内窥镜和胸腔镜技术的利用。尽管MIS技术尚处于起步阶段，但越来越多的研究报告称使用这些MIS技术具有良好的临床和放射学结果。但是，文献仍然缺乏将这些较新技术与经典开放疗法进行比较的高质量证据。本文回顾了有关微创脊柱外科手术治疗胸腰椎和腰椎创伤的相关文献。

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