C-arm free reduction for thoracolumbar fracture: A technical note

Background: Percutaneous pedicle screw (PPS) fixation as a minimally invasive surgery (MIS) is becoming the standard method for stabilizing thoracolumbar burst fractures. However, with the conventional PPS percutaneous reduction is difficult, and a great amount of usage of fluoroscopy is necessary. We describe a novel technique of C-arm free PPS with new reduction device for thoracolumbar fractures. Methods: A 22-year-old man presented to our hospital with severe low back pain and impending paraplegia secondary to T12 burst fracture. We performed short-segment fixation and reduction for this patent. The special PPS which have reduction mechanism were inserted under O-arm navigation guidance. The trauma reduction system was applied and the fracture was reduced without fluoroscopy. Results: Postoperative computed tomography (CT) showed the adequate screws position and complete reduction of the vertebral body. On one-year follow-up, the patient was asymptomatic, with the fracture healed and no implant loosening. Conclusions: C-arm free PPS and reduction is a useful MIS technique for thoracolumbar burst fractures.