Publication:

Analysis of outcome of percutaneous versus open pedicle screw fixation in the treatment of thoraco-lumbar spine fractures: a prospective comparative study

Background Aim of the study was to evaluate the effectiveness between percutaneous and open pedicle screw fixation in the treatment of traumatic thoracolumbar burst fractures with spinal injury.

Methods A prospective comparative study including thirty patients with thoracolumbar burst fracture were equally divided into an open pedicle screw fixation (OPSF) group and a percutaneous pedicle screw fixation (PPSF) group. Demographic characteristics, clinical and radiological outcomes, and adverse events were assessed and compared between the 2 groups.

Results Demographic and clinical features including age, gender, fracture level, mechanism of injury and neurological status in both groups were not significantly different (all p>0.05). The PPSF group exhibits significantly lower operative time, intraoperative blood loss, and hospital stay compared with the OPSF group (all p 0.05). Visual analogue scale (VAS) remarkably decreased in both groups after surgery but difference was not statically significant (p=0.808). Common postoperative complications in both groups were superficial infections, pressure ulcer and urinary tract infection (UTI) worsening. Hardware failure was seen only in one case of PPSF group.

Conclusions Patients with thoracolumbar burst fractures can be effectively managed with PPSF/OPSF. There were no significant differences in radiological and clinical outcomes and post-op complications between 2 groups but blood loss, operative time and hospitalization stay were less in percutaneous group, which may represent a potential benefit.