Efficacies Of Minimally Invasive Percutaneous Pedicle Screw Fixation Versus Open Pedicle Screw Fixation On The Treatment Of Type A Vertebral Fractures At The Thoracolumbar Junction

Objective: To compare the efficacies of minimally invasive percutaneous pedicle screw fixation (MIPPSF) with open pedicle screw fixation (OPSF) on the treatment of type A vertebral fractures at the thoracolumbar junction. Methods: A total of 97 patients with type A vertebral fractures at the thoracolumbar junction who were admitted to our hospital were selected as the study subjects and divided into the minimally invasive group (n=42) and the open group (n=45) according to different surgical treatment. The open group received OPSF, and the minimally invasive group received MIPPSF. The efficacies of OPSF and MIPPSF were compared. Results: There was no significant difference in the duration of surgery between the two groups (P> 0.05). The minimally invasive group had less intraoperative blood loss and shorter incision length and postoperative hospital stay than the open group (P < 0.05). There were significant differences in the height and the self-angulation of the anterior edge of the injured vertebra between the two groups after surgery, at the last visit and within groups before surgery (P < 0.05), but there was no significant difference in the comparison within groups (P > 0.05). On Day 1, 3, 7 and 14 after surgery, the visual analog scale (VAS) scores in the minimally invasive group were lower than those in the open group (P < 0.05). The minimally invasive group exhibited higher Oswestry Disability Index (ODI) scores at month 3 and 6 after surgery and higher scores of lumbar vertebrae functions at month 1, 3 and 6 after surgery than the open group (P < 0.05). Conclusion: Compared with OPSF, MIPPSF is more effective in the treatment of type A vertebral fractures at the thoracolumbar junction. MIPPSF can markedly reduce trauma, intraoperative bleeding and postoperative pain, expedite the postoperative discharge, quickly alleviate dysfunction, and improve lumbar vertebrae functions.