Open vs Percutaneous Pedicle Instrumentation for Kyphosis Correction in Traumatic Thoracic and Thoracolumbar Spine...

Area of Science:

• Orthopedic Surgery
• Spinal Trauma Management
• Minimally Invasive Techniques

Background:

• Percutaneous pedicle instrumentation (PPI) is utilized for thoracic and thoracolumbar (TL) trauma.
• The efficacy of PPI in correcting significant post-traumatic kyphosis requires further evaluation.

Purpose of the Study:

• To compare kyphosis correction between PPI and traditional open posterior approaches for thoracic and TL trauma.
• To assess the correction of significant post-traumatic kyphotic deformities.

Main Methods:

• Retrospective study of 91 patients with thoracic (T1-T9) or TL (T10-L2) fractures and ≥15° kyphosis.
• Patients divided into open posterior approach and PPI cohorts.
• Kyphosis measured by Cobb angle on CT and radiographs; immediate and follow-up correction compared.

Main Results:

• No significant difference in immediate correction (11° for both groups) or loss of correction (1° for both groups) between PPI and open surgery.
• Obesity (BMI >30 kg/m²) and AO type-A fractures were associated with significantly less correction.
• Each unit increase in BMI correlated with a 0.75° decrease in correction.

Conclusions:

• PPI achieves equivalent postoperative angular correction and maintenance compared to open surgery in thoracic and TL trauma.
• Both techniques are viable options for treating significant traumatic kyphotic deformities.