Traitement chirurgical mini-invasif des fractures de la jonction thoracolombaire en flexion distraction (type B Magerl) : à propos de trois cas

Background and purpose

Chance fractures are quite rare injuries that require surgical treatment in cases of spinal instability. Development of percutaneous and minimally invasive procedures can alter the management of such lesions, resulting in fewer related soft tissue lesions and morbidities.

Methods

We present our experience with three patients who underwent percutaneous posterior osteosynthesis associated with a minimally invasive anterior graft for discal lesion. The first two cases presented fracture through the disc and osteosynthesis was done on a single mobile level. In the third case with a bony Chance fracture, we performed a short-segment fixation one level above and below the fractured vertebra.

Results

In all three cases, operative blood loss was minimal and clinical outcomes were favorable, with tolerable postoperative pain. Fusion and consolidation were visible for all the patients without loss of correction or implant failure.

Conclusion

Percutaneous osteosynthesis and minimally invasive surgery can be an advantageous alternative for the management of Chance fractures. They allow early mobilization of the patient with less soft tissue trauma and morbidities associated with open procedures.