[Comparative percutaneous with open pedicle screw fixation in the treatment of thoracolumbar burst fractures without neurological deficit].
OBJECTIVE
To compare clinical outcome of the percutaneous versus open pedicle screw fixation in the treatment of thoracolumbar burst fracture with neurological intact.


METHODS
Sixty patients with thoracolumbar burst fracture without neurological deficit underwent either percutaneous (n = 30) or traditional open pedicle screw fixation (n = 30). Radiographs obtained before surgery, immediately after surgery, 4 months and 2 years after surgery were used to access the restoration of spinal anatomy. Also, operation time, blood loss, blood drainage, hospital stay and soft tissue dissection were evaluated. The level of pain was assessed by visual analog scale (VAS), function by the Oswestry questionnaire.


RESULTS
The average followed up was 2 years. There were no significant differences between both groups concerning age, sex, cause of injury and the presence of other severe injuries. Significant differences were observed between the two groups in blood loss, blood drainage, hospital stay and soft tissue dissection (P < 0.01), whereas no significant differences in operation time (P > 0.05). The vertebral height, the kyphosis angle, and the occupation of spinal canal after surgery and at follow-up were not significantly (P > 0.05). The pain systems and functions were similar in both groups at final follow-up (P > 0.05), however, less pain was found in the percutaneous group than that in the open group at the first 3 months after surgery (P < 0.01).


CONCLUSIONS
Percutaneous pedicle screw fixation for thoracolumbar fracture has the advantage of less trauma, quickly recovery and better esthetic outcome, however, it has the same results with the traditional open produce after 2 years of surgery.
Department of Orthopaedics, Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, China. hqshaq@yahoo.com.cn
Qi-Shan
QS
Huang
Yong-Long
YL
Chi
Xiang-Yang
XY
Wang
Fang-Min
FM
Mao
Yan
Y
Lin
Wen-Fei
WF
Ni
Hua-Zi
HZ
Xu
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome