Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2026; 93(3):156-161 | DOI: 10.55095/achot2026/022

Percutaneous Stabilization of the Thoracolumbar Spine: Indications, Limitations and Cohort Analysis

JAKUB JEŽEK, JAN ŠVEC, MARTIN KAPOUNEK, JIŘÍ SKÁLA-ROSENBAUM

Ortopedicko-traumatologická klinika 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha

Percutaneous stabilization of the thoracolumbar spine represents a minimally invasive alternative to open posterior fixation. The aim of this study was to evaluate the indications, perioperative parameters, and limitations of this method in a single-center patient cohort.



A retrospective analysis of 65 consecutive patients treated with percutaneous transpedicular stabilization of the thoracolumbar spine between 2021 and 2025 was performed. All procedures were carried out using an intraoperative CT-based navigation system (O-arm). Demographic data, primary diagnosis, extent of instrumentation, additional procedures, operative time, blood loss, length of hospital stay, and complications were evaluated.



The most common indication was trauma (75.4%), followed by metastatic disease (13.8%), and infection (10.8%). Placement of 8 screws was used most commonly (78.5%). The mean operative time was 104 minutes, and the mean blood loss was 141 ml. When patients who underwent decompression were excluded, the mean blood loss decreased to 112 ml (14 ml per screw). The mean length of hospital stay was 11.4 days and dropped to 6.7 days after excluding patients with concomitant factors. No pedicle screw malposition was observed. Revision surgery was required in 7 patients.

Discussion: Percutaneous stabilization is associated with low blood loss and favourable postoperative outcomes. A more detailed analysis suggests that the percutaneous instrumentation itself is a low-blood-loss procedure, while overall perioperative parameters are significantly influenced by the scope of combined surgical procedures. Proper patient selection remains crucial.

Conclusions: Percutaneous stabilization is an effective and less invasive method, particularly suitable for patients in whom deformity correction or posterior fusion is not required. The greatest benefit is observed in polymorbid, polytraumatized and oncological patients, where minimizing surgical burden is essential. Appropriate indication and awareness of the method's limitations are key to achieving optimal outcomes.

Keywords: percutaneous spine stabilization, thoracolumbar spine, pedicle screw fixation, intraoperative navigation, minimally invasive surgery, spondylodiscitis, metastatic spine disease.

Received: March 23, 2026; Revised: March 23, 2026; Accepted: April 22, 2026; Published: July 1, 2026  Show citation