Comparative Outcomes of Percutaneous and Conventional Open Pedicle Screw Fixation for Single-level Thoracolumbar Spine Injury: Randomised Controlled Trial

Choovongkomol K; Piyapromdee U; Thepjung S; Tanaviriyachai T; Jongkittanakul S; Sudprasert W

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Comparative Outcomes of Percutaneous and Conventional Open Pedicle Screw Fixation for Single-level Thoracolumbar Spine Injury: Randomised Controlled Trial

Author: Choovongkomol K ¹ ; Piyapromdee U ¹ ; Thepjung S ¹ ; Tanaviriyachai T ¹ ; Jongkittanakul S ¹ ; Sudprasert W ¹
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1. Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
Publication Type:Journal Article
Keywords: spinal fracture, thoracolumbar spine, pedicle screws, minimal invasive surgery
From:Malaysian Orthopaedic Journal 2024;18(No.1):106-115
CountryMalaysia
Language:English
Abstract: Introduction: To compare post-operative outcomes of percutaneous pedicle screw fixation (PPSF) vs open pedicle screw fixation (OPSF) in patients with thoracolumbar spine fractures with no neurological deficits. Materials and methods: In a randomised controlled trial, patients received short-segment fixation with intermediate screws. We assessed post-operative back pain (Visual Analog Scale or VAS), blood loss, operative/fluoroscopy times, radiographic parameters, and oswestry disability index (ODI) scores at 1, 2, 3, 6, 9, and 12 months. Results: Between January 2018 and October 2019, 31 patients received PPSF and 30 OPSF. Mean intra-operative blood loss was 66.45 (±44.29) ml for PPSF vs 184.83 (±128.36) ml for OPSF (p<0.001). Fluoroscopy time averaged 2.36 (±0.76) minutes for PPSF vs 0.58 (±0.51) minutes for OPSF (p<0.001). No significant differences existed in operative time or post-operative VAS scores. Radiographic parameters (kyphosis angle and vertebral height ratios) didn't significantly differ post-operatively or at 12 months. However, ODI scores differed significantly at 6 months (p=0.025), with no difference at 12 months. Conclusion: In this trial, PPSF was comparable to OPSF in improving ODI scores at 12 months but showed earlier improvement at 6 months and reduced blood loss. Radiographic outcomes remained similar between groups over 12 months.
Full text:202408121245509755816.2024my1358.pdf