Comparison of open versus percutaneous pedicle screw insertion in a sheep model

Minimally invasive surgery has become more and more important for the treatment of traumatic spine fractures. Besides, some clinical studies, objective data regarding the possible lower damage to the surrounding tissue of the spine is still missing. Here we report a sheep model where we compared a p...

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Bibliographic Details
Published in:European spine journal 2008-06, Vol.17 (6), p.857-863
Main Authors: Lehmann, W., Ushmaev, A., Ruecker, A., Nuechtern, J., Grossterlinden, L., Begemann, P. G., Baeumer, T., Rueger, J. M., Briem, D.
Format: Article
Language:English
Subjects:
Animals
Bone Screws
Electromyography
Lumbar Vertebrae - surgery
Medicine
Medicine & Public Health
Minimally Invasive Surgical Procedures - methods
Models, Animal
Muscle, Skeletal - surgery
Neurosurgery
Original
Original Article
Orthopedic Procedures - methods
Sheep
Surgical Orthopedics
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Summary:Minimally invasive surgery has become more and more important for the treatment of traumatic spine fractures. Besides, some clinical studies, objective data regarding the possible lower damage to the surrounding tissue of the spine is still missing. Here we report a sheep model where we compared a percutaneous versus an open approach for dorsal instrumentation with pedicle screws to the spine. Twelve skeletally mature sheep underwent bilateral pedicle screw fixation at the L4–L6 level. Forty-eight pedicle screws were bilaterally inserted into the pedicles and connected with rods using either an open dorsal standard or a percutaneous approach. Operation time, blood flow, compartment pressure, radiation time, loss of blood, laboratory findings and EMG were evaluated to objectify possible advantages for the percutaneous operation technique. Loss of blood and the distribution of CK-MM as a marker for muscle damage were significantly lower in the percutaneous group. However, radiation time was significantly longer in the percutaneous group. Other parameters like compartment pressure, blood flow and also measurement of the EMG at different time points did not reveal significant differences. Based on the results we found in the present study, percutaneous screw insertion can bring moderate advantages but it should be noted that essential functional deficits to the muscle could not be detected.
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-008-0652-7