Systematic review and meta-analysis of the effect of using percutaneous pedicle screw internal fixation for thoracolumbar fractures

Abstract

Background: Thoracolumbar fractures are common in routine injuries. The best way to treat a thoracolumbar fracture is to repair the thoracic fracture with fixation, which is classified into percutaneous pedicle screw fixation and open pedicle screw fixation. Methods:The literature was searched in the English database PubMed, Ovid-Medline, Embase, and China Biology Medicine Disc (CBM) from the date of establishment of PubMed to June 2021, and keywords such as percutaneous pedicle screw and posterior percutaneous pedicle screw fixation were searched. A metaanalysis was performed using RevMan5.3, which was provided by Cochrane.com.Results: A total of 9 articles were included. The results showed that the operative time of percutaneous pedicle screw fixation was shorter than that of open pedicle screw fixation. Percutaneous pedicle screw internal fixation had better Cobb angle restoration effect than open pedicle screw internal fixation. However, there were considerable differences in pain and screw misplacement rates. In addition, the pain after percutaneous pedicle screw fixation was smaller than that after open pedicle screw fixation, and patients had better compliance. Discussion: Compared with open surgery, percutaneous pedicle screw fixation had a shorter operation time, better cobb angle recovery, and a lower pain sensation following surgery. The low rate of screw misplacement and postoperative infection suggested that percutaneous pedicle screw fixation was more effective than open surgery.

Evaluation of minimally invasive percutaneous transpedicular screw fixation as an evolving modality for the treatment of thoracolumbar fractures

“…Several studies and recently published meta-analyses reported an average Cobb's angle correction of 5.5 degrees. These studies also reported that with using percutaneous screw fixation, a significant improvement in the height of anterior body fracture and the canal compression usually occurred [15,[21][22][23][24].…”

Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review

“…This could be explained due to the low amount of studies that reported on this subject and the differences between the patient population of the studies. The included studies by Phan et al (2015) and Lu et al (2022) compared PP with PO and reported a shorter hospital stay, shorter operation time, lower infection rates and better pain scores following surgery, while maintaining similar radiographic outcome data ( Lu et al, 2022 ; Phan et al, 2015 ). However, PP requires a longer learning curve and may expose the surgeon to more radiation ( Court and Vincent, 2012 ).…”

“…Various meta-analysis and narrative reviews have been published on the treatment of traumatic thoracic and lumbar fractures of the spine ( Xu et al, 2013 ; Lu et al, 2022 ; McAnany et al, 2016 ; Phan et al, 2015 ; Yi et al, 2006 ; Hughes et al, 2021 ; Sun et al, 2017 ; Tan et al, 2019 ; Kim et al, 2015 ; Pneumaticos et al, 2013 ). However, no comprehensive up-to-date overview is available of the different surgical methods, while using quantified outcome data.…”

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

“…Patients experience significant muscle strain and fracture trauma during open arch root nail internal fixation surgery treatment, and plasma CK levels are significantly elevated [ 23 ]. Open arch root nail internal fixation surgical treatment requires paravertebral muscle distraction under the guidance of an automatic retractor, and paravertebral muscle ischemia is evident, which will further reduce the risk of lumbar back muscle ischemia and increase the pain level of patients [ 24 , 25 ]. The application of minimally invasive pedicle screw internal fixation can reduce the risk of denervation atrophy, the VAS score is significantly reduced, the intraoperative drainage volume and blood loss are reduced, and the patient's lumbar spine function and daily living ability are significantly restored.…”