Perkutane dorsale Instrumentierung der thorakolumbalen Wirbelsäule

Minimally invasive percutaneous instrumentations are increasingly being used for stabilization of thoracolumbar fractures, mainly due to the advantages of reduced soft tissue damage. While percutaneous instrumentation can be generally used in less displaced fractures, it remains controversial whether such techniques should also be performed in patients with severe fracture dislocation. This includes patients with severe traumatic kyphosis and/or dislocation in the coronar plane, particularly in concomitant neurological deficits that require additional decompression surgery. Here we show the different indirect fracture reduction techniques in three cases with severe fracture dislocation and discuss the use of percutaneous stabilization techniques in combination with an additional midline approach for decompressing laminectomy.