title: Comparison between percutaneous and traditional fixation of lumbar spine fracture: intraoperative radiation exposure levels and outcomes.
abstract: OBJECTIVE
  To compare radiation exposure doses and clinical and radiological outcomes between percutaneous pedicular screwing (closed reduction internal fixation [CRIF]) and classical open reduction internal fixation (ORIF) in lumbar spine fracture without neurologic deficit.
  
  
  METHODS
  Sixty patients (mean age, 42.5 years) were divided into two treatment groups: (Percutaneous) CRIF versus (traditional) ORIF. Screw position and anatomic vertebral reconstruction were checked on routine control X-ray and postoperative CT scan. Study parameters comprised: surgery time, radiation exposure time, radiation dose level for X-ray (DAP) and for CT (DLP),blood loss, length of hospital stay and postoperative pain (VAS).
  
  
  RESULTS
  At a mean 25.5 months' follow-up,there were no significant inter-group differences on the epidemiological parameters: age, gender, fracture level, fracture type on the Magerl classification, preoperative local vertebral kyphosis angle, or fracture-to-surgery interval. Effective radiation dose was 3-fold higher in CRIF than in ORIF, but 6-fold lower than for the postoperative CT scan. Postoperative pain on VAS was significantly lower after CRIF, allowing earlier gait resumption and return to work and daily activity. There were no significant differences in length of hospital stay, patient satisfaction, screw malpositioning or postoperative or end-of-follow-up kyphosis angle.
  
  
  CONCLUSIONS
  Percutaneous surgery provided clinical and radiological outcomes strictly comparable to those of open surgery, but with a higher effective radiation exposure dose, including for the medical team and especially for the surgeon. This higher exposure dose, however, is to be relativized by comparison to that of the postoperative CT scan, which involved a much higher exposure dose for the patient.
  
  
  METHODS
  Level IV. Retrospective study.
authors: Nice University Hospital Center, Orthopedic and Traumatologic Surgery Department, Hôpital Saint Roch, 5, rue Pierre-Dévoluy, 06000 Nice, France. nicolas.bronsard@mac.com
authors: N
authors: N
authors: Bronsard
authors: T
authors: T
authors: Boli
authors: M
authors: M
authors: Challali
authors: R
authors: R
authors: de Dompsure
authors: N
authors: N
authors: Amoretti
authors: B
authors: B
authors: Padovani
authors: G
authors: G
authors: Bruneton
authors: A
authors: A
authors: Fuchs
authors: F
authors: F
authors: de Peretti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011829:Radiation Dosage; D016103:Spinal Fractures / Q000601:surgery*; D055815:Young Adult