SPINE FIXATION FOR PATIENTS WITH POLYTRAUMA PLACED IN THE LATERAL POSITION USING THE PERCUTANEOUS PEDICLE SCREW SYSTEM : A REPORT OF 4 CASES

Abstract

　　Early spinal stabilization cannot be achieved in all patients with polytrauma because some cannot tolerate being placed in the prone position due to the severity of concurrent injuries. We report four patients who were placed in the lateral position due to severe chest injury and who underwent spine fixation using a percutaneous pedicle screw (PPS). The mean ISS score was 46.2 (range, 33-66). We inserted the PPS in the right lateral position using a computed tomography navigation system. The accuracy of screw insertion was 94.4% and there were no neurological side effects. The patients were encouraged to undergo respiratory rehabilitation after fixation. The insertion of a PPS in the lateral position enables early fixation of an injured spine in patients with polytrauma who cannot be placed in the prone position.