An Innovative Minimally Invasive Delta Fixation for Thoracolumbar Fracture With Diffuse Idiopathic Skeletal Hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH) is a relatively common disease for elderly people, characterized by a tendency of ossification of ligaments and tendons. Spinal fracture in patients with diffuse idiopathic skeletal hyperostosis is a very unstable fracture and usually needs posterior long spinal fixation. Conventional pedicle screw fixation is the standard method for these ankylosed spines. However, with the traditional technique, screw loosening, screw pullout, implant failure, and nonunion are often encountered due to the osteoporotic bone. Recently, transdiscal screw fixation for this fracture was reported as a strong anchor for the osteoporotic spine. Furthermore, triangular fixation, which is the combination of transdiscal screws and downward screws, has reported excellent results for long posterior spinal fusion for adult spinal deformity. We present an 86-year-old male with severe low back pain due to an L1 fracture treated with a novel minimally invasive technique via delta fixation technique.