Thoracolumbar Spine Trauma

  • Kelley E. Banagan
  • Daniel L. Cavanaugh
  • Ian Bussey
  • Alysa Nash
  • Jael E. Camacho-Matos
  • M. Farooq Usmani
  • Steven C. LudwigEmail author


During the past decade, minimally invasive spinal surgical techniques have become widely accepted to treat degenerative conditions, tumors, infections, and deformities. Minimally invasive techniques are now also being used to treat thoracolumbar spine trauma. The advantages of minimally invasive spine surgery include decreased blood loss and decreased infection rates, with similar efficacy to that of more invasive techniques. Minimally invasive surgical stabilization of thoracolumbar trauma has also been shown to be a viable treatment option in a “damage control orthopedics” setting, in which traditional open approaches might not be possible.


Minimally invasive spine surgery Thoracolumbar Trauma Damage control orthopedics Fracture 



The authors thank Senior Editor and Writer Dori Kelly, MA, for invaluable assistance with the manuscript.


  1. 1.
    Holmes JF, Miller PQ, Panacek EA, Lin S, Horne NS, Mower WR. Epidemiology of thoracolumbar spine injury and blunt trauma. Acad Emerg Med. 2001;8(9):866–72.CrossRefGoogle Scholar
  2. 2.
    Grazier K, Holbrook TL, Kelsey JL, Stauffer RN. The frequency of occurrence, impact, and costs of musculoskeletal conditions in the United States. Rosemont: American Academy of Orthopaedic Surgeons; 1984.Google Scholar
  3. 3.
    Gertzbein SD. Scoliosis research society: multicenter spine fracture study. Spine (Phila Pa 1976). 1992;17(5):528–40.CrossRefGoogle Scholar
  4. 4.
    Hu R, Mustard CA, Burns C. Epidemiology of incident spinal fracture in a complete population. Spine (Phila Pa 1976). 1996;21(4):492–9.CrossRefGoogle Scholar
  5. 5.
    The National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. Birmingham: The University of Alabama; 2011.Google Scholar
  6. 6.
    DeVivo MJ, Chen Y, Mennemeyer ST, Deutsch A. Costs of care following spinal cord injury. Top Spinal Cord Inj Rehabil. 2011;16(4):1–9.CrossRefGoogle Scholar
  7. 7.
    Cao Y, Chen Y, DeVivo M. Lifetime direct cost after spinal cord injury. Top Spinal Cord Inj Rehabil. 2011;16(4):10–6.CrossRefGoogle Scholar
  8. 8.
    Koreckij T, Park DK, Fischgrund J. Minimally invasive spine surgery in the treatment of thoracolumbar and lumbar spine trauma. Neurosurg Focus. 2014;37(1):E11.CrossRefGoogle Scholar
  9. 9.
    Williams SK. Thoracic and lumbar spinal injuries. In: Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, Balderston RA, editors. Rothman-Simeone the spine. 6th ed. Philadelphia: Elsevier Saunders; 2011. p. 1132–56.Google Scholar
  10. 10.
    Kaneda K, Abumi K, Fujiya M. Burst fractures with neurologic deficits of the thoracolumbar-lumbar spine: results of anterior decompression and stabilization with anterior instrumentation. Spine (Phila Pa 1976). 1984;9(8):788–95.CrossRefGoogle Scholar
  11. 11.
    Kallemeier PM, Beaubien BP, Butterman GR, Polga DJ, Wood KB. In vitro analysis of anterior and posterior fixation in an experimental unstable burst fracture model. J Spinal Disord Tech. 2008;21(3):216–24.CrossRefGoogle Scholar
  12. 12.
    Lee MC, Fox K, Fessler RG. Minimally invasive spinal surgery: evidence-based review of the literature. In: Scuderi GR, Tria AJ, editors. Minimally invasive surgery in orthopaedics. New York: Springer; 2010. p. 529–33.CrossRefGoogle Scholar
  13. 13.
    Phan K, Roa PJ, Mobbs RJ. Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: systematic review and meta-analysis of comparative studies. Clin Neurol Neurosurg. 2015;135:85–92.CrossRefGoogle Scholar
  14. 14.
    Rechtine GR, Bono PL, Cahill D, Bolesta MJ, Chrin AM. Postoperative wound infection after instrumentation of thoracic and lumbar fractures. J Orthop Trauma. 2001;15(8):566–9.CrossRefGoogle Scholar
  15. 15.
    Gomez JA, Ludwig SC. Minimally invasive techniques for thoracolumbar spinal trauma. Comtemp Spine Surg. 2012;131:7.Google Scholar
  16. 16.
    Verlaan JJ, Diekerhof CH, Buskens E, van der Tweel I, Verbout AJ, Dhert WJ, et al. Surgical treatment of traumatic of thoracic and lumbar spine: a systematic review of the literature on techniques, complications, and outcome. Spine (Phila Pa 1976). 2004;29(7):803–14.CrossRefGoogle Scholar
  17. 17.
    O’Toole JE, Eichholz KM, Fessler RG. Surgical site infection rates after minimally invasive spinal surgery. J Neurosurg Spine. 2009;11(4):471–6.CrossRefGoogle Scholar
  18. 18.
    Rodgers WB, Gerber EJ, Patterson J. Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases. Spine (Phila Pa 1976). 2011;36(1):26–32.CrossRefGoogle Scholar
  19. 19.
    Patel AA, Vaccaro AR. Thoracolumbar spine trauma classification. J Am Acad Orthop Surg. 2010;18(2):63–71.CrossRefGoogle Scholar
  20. 20.
    McAnany SJ, Overley SC, Kim JS, Baird EO, Qureshi SA, Anderson PA. Open versus minimally invasive fixation techniques for thoracolumbar trauma: a meta-analysis. Global Spine J. 2016;6(2):186–94.CrossRefGoogle Scholar
  21. 21.
    Jazini E, Weir T, Nwodim E, Tannous O, Saifi C, Caffes N, et al. Outcomes of lumbopelvic fixation in the treatment of complex sacral fractures using minimally invasive surgical techniques. Spine J. 2017;17(9):1238–46.CrossRefGoogle Scholar
  22. 22.
    Wang MY, Ludwig SC, Anderson DG, Mummaneni PV. Percutaneous iliac screw placement: description of a new minimally invasive technique. Neurosurg Focus. 2008;25(2):E17.CrossRefGoogle Scholar
  23. 23.
    Williams SK, Quinnan SM. Percutaneous lumbopelvic fixation for reduction and stabilization of sacral fractures with spinopelvic dissociation patterns. J Orthop Trauma. 2016;30(9):e318–24.CrossRefGoogle Scholar
  24. 24.
    Karp JE, Ludwig SC. Trauma MIS. Tech Orthop. 2011;26(3):188–93.CrossRefGoogle Scholar
  25. 25.
    Kumar A, Aujla R, Lee C. The management of thoracolumbar burst fractures: a prospective study between conservative management, traditional open spinal surgery and minimally interventional spinal surgery. Springerplus. 2015;4:204.CrossRefGoogle Scholar
  26. 26.
    Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J. 1994;3(4):184–201.CrossRefGoogle Scholar
  27. 27.
    Palmisani M, Gasbarrini A, Brodano GB, De lure F, Cappuccio M, Boriani L, et al. Minimally invasive percutaneous fixation in the treatment of thoracic and lumbar spine fractures. Eur Spine J. 2009;18(Suppl 1):71–4.CrossRefGoogle Scholar
  28. 28.
    Smith WD, Dakwar E, Le TV, Christian G, Serrano S, Uribe JS. Minimally invasive surgery for traumatic spinal pathologies: a mini-open, lateral approach in the thoracic and lumbar spine. Spine (Phila Pa 1976). 2010;35(Suppl 26):S338–46.CrossRefGoogle Scholar
  29. 29.
    Eck JC. Minimally invasive corpectomy and posterior stabilization for lumbar burst fracture. Spine J. 2011;11(9):904–8.CrossRefGoogle Scholar
  30. 30.
    Tomycz L, Parker SL, McGirt MJ. Minimally invasive transpsoas L2 corpectomy and percutaneous pedicle screw fixation for osteoporotic burst fracture in the elderly: a technical report. J Spinal Disord Tech. 2015;28(2):53–60.CrossRefGoogle Scholar
  31. 31.
    Kim DH, Jahng TA, Balabhadra RS, Potulski M, Beisse R. Thoracoscopic transdiaphragmatic approach to thoracolumbar junction fractures. Spine J. 2004;4(3):317–28.CrossRefGoogle Scholar
  32. 32.
    Harris EB, Massey P, Lawrence J, Rihn J, Vaccaro A, Anderson DG. Percutaneous techniques for minimally invasive posterior lumbar fusion. Neurosurg Focus. 2008;25(2):E12.CrossRefGoogle Scholar
  33. 33.
    Wang MY, Anderson DG, Ludwig SC, Mummanein PV. Handbook of minimally invasive and percutaneous spine surgery. St. Louis: Quality Medical Publishing; 2011.Google Scholar
  34. 34.
    Beisse R, Mückley T, Schmidt MH, Hauschild M, Bühren V. Surgical technique and results of endoscopic anterior spinal canal decompression. J Neurosurg Spine. 2005;2(2):128–36.CrossRefGoogle Scholar
  35. 35.
    Lall RR, Smith ZA, Wong AP, Miller D, Fessler RG. Minimally invasive thoracic corpectomy: surgical strategies for malignancy, trauma, and complex spinal pathologies. Minim Invasive Surg. 2012;2012:213791.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Moskovich R, Benson D, Zhang ZH, Kabins M. Extracoelomic approach to the spine. J Bone Joint Surg Br. 1993;75(6):886–93.CrossRefGoogle Scholar
  37. 37.
    Khan SN, Cha T, Hoskins JA, Pelton M, Singh K. Minimally invasive thoracolumbar corpectomy and reconstruction. Orthopedics. 2012;35(1):e74–9.PubMedGoogle Scholar
  38. 38.
    McHenry TP, Mirza SK, Wang J, Wade CE, O’Keefe GE, Dailey AT, Schreiber MA, Chapman JR. Risk factors for respiratory failure following operative stabilization of thoracic and lumbar spine fractures. J Bone Joint Surg Am. 2006;88:997–1005.CrossRefGoogle Scholar
  39. 39.
    Banagan K, Ludwig SC. Thoracolumbar spine trauma: when damage control minimally invasive spine surgery is an option. Semin Spine Surg. 2012;24(4):221–5.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Kelley E. Banagan
    • 1
  • Daniel L. Cavanaugh
    • 2
  • Ian Bussey
    • 1
  • Alysa Nash
    • 1
  • Jael E. Camacho-Matos
    • 1
  • M. Farooq Usmani
    • 1
  • Steven C. Ludwig
    • 1
    Email author
  1. 1.Department of Orthopaedics, Spine DivisionUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of Orthopaedic SurgeryUniversity of North CarolinaChapel HillUSA

Personalised recommendations