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Open versus percutaneous short-segment posterior instrumentation in thoracolumbar junction burst fractures
Yücel Bilgin1, Saltuk Buğra Güler2, Burak Akesen1
1Department of Orthopedics and Traumatology, Bursa Uludag University, Faculty of Medicine, Bursa-Türkiye.
Background:
This research aimed to compare the surgical data and the clinical and radiological results of patients who under-went open posterior versus percutaneous posterior instrumentation for burst-type spinal fractures in the thoracolumbar junction.
Methods:
This study included 73 patients; 43 underwent open posterior instrumentation, and 30 underwent percutaneous posterior instrumentation. Perioperative parameters included the time between fracture and surgery, duration of surgery, perioperative blood loss, fluoroscopy duration, and total length of hospital stay. Clinical evaluation was performed using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Preoperative, postoperative, 7th-day, and last follow-up values were analyzed. Radiological evaluation included the anterior vertebral body height ratio (AVBHR) and Cobb angle.
Results:
Fluoroscopy time was significantly longer in the percutaneous surgery group than in the open surgery group (12.77+-1.89 minutes vs. 4.33+-1.24 minutes; p<0.001). Hospitalization time was significantly longer in the open surgery group (3.79+-1.53 days vs. 2.13+-0.76 days; p<0.001). VAS scores differed significantly between the open and percutaneous surgery groups on the 7th postoperative day (p=0.02) and at the last follow-up (p=0.02). Similarly, lower ODI scores were observed in the percutaneous group compared to the open surgery group on the 7th postoperative day and at the last follow-up (p<0.001). Regarding radiological outcomes, significant postoperative improvements were achieved in both groups in terms of AVBHR, but differences in the Cobb angle in the sagittal plane were not statistically significant (p=0.07).
Conclusion:
According to the results of this study, the percutaneous surgery group showed significantly better improvement in VAS and ODI scores on postoperative day 7 and at the final follow-up. Similar postoperative improvements were achieved in both groups in terms of AVBHR and sagittal Cobb angle.
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Assessment:
1. Clinical Evaluation:
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