COMPARISON OF PERCUTANEOUS PEDICLE SCREW FIXATION AND PEDICAL SCREW FIXATION IN CONVENTIONAL INCISION IN THORACOLUMBAR FRACTURE

Abstract

Background: Originally, patients with unstable thoracolumbar spine fracture were treated using pedicle screw fixation, a conventional incision. However, the small incision percutaneous pedicle screw fixation (PPSF), a new device, has been recently introduced which could save surgery time, reduce blood loss and improve clinical recovery.
 Objective: This study aimed to evaluate postoperative outcomes of the PPSF, compared with the open pedicle screw fixation (OPSF) in conventional incision among patients with thoracolumbar fracture.
 Methods: A retrospective study of 54 cases of patients with thoracolumbar spine fracture without neurological deficit was included in the study. The data were collected from medical records of patients admitted to Rayong Hospital from January 2017-December 2019. Results: Patients aged from 18-46 years (32.35+ 8.52) were mostly males (59.2%). Types of fracture included burst (72.22%). The most common level of thoracolumbar spine fracture was L1 (37.04%). Mostly, the cause of injury was fall from height (53.70%). The mean postoperative stays in the PPSF and OPSF groups were significant, 3.09±.59 and 6.16±1.003 days, respectively (p<0.05). The mean intraoperative blood losses of the PPSF and OPSF groups significantly differed, 44.35±15.02 and 466.13±87.92 mL, respectively (p < 0.01). However, the mean kyphotic angle reduction of the PPSF (24.43±2.74 degrees) and OPSF (24.87±2.55 degrees) groups did not significantly differ (p > 0.1). The mean postoperative pain score (VAS) at the first day in the PPSF and OPSF groups were 6.43±.94 and 6.61±.98, respectively, which did not significantly differ (p > 0.1).
 Conclusion: PPSF spinal fracture treatment could reduce the amount of bleeding during surgery and reduce the length of hospital stay. However, the results of both types of surgery did not differ regarding postoperative pain, decreased kyphotic angle and surgical time.