Comparison of Outcomes between Minimal Invasive Spine Stabilization and Open Conventional Approach in Thoracolumbar Traumatic Spine Fractures
DOI:
https://doi.org/10.70749/ijbr.v3i7.2352Keywords:
Thoracolumbar Fractures, Minimally Invasive Spine Stabilization, Open Conventional Approach, Operative Time, Postoperative Pain, Hospital Stay, Early Mobilization, Spine Surgery Outcomes.Abstract
Background: Thoracolumbar traumatic spine fractures represent one of the most frequent spinal injuries, often necessitating surgical stabilization. While open conventional fixation has been the established method, minimally invasive spine stabilization (MISS) has gained attention due to its potential advantages in reducing surgical morbidity. This study aimed to compare outcomes between MISS and the open conventional approach in patients with thoracolumbar traumatic fractures. Methods: A quasi-experimental study was conducted in the Department of Neurosurgery, Sheikh Zayed Hospital, Rahim Yar Khan, from January to May 2025. Seventy-six patients meeting eligibility criteria were enrolled and equally assigned to MISS or open conventional fixation groups (38 each). Outcomes assessed included operative time, postoperative pain (Numerical Rating Scale, day seven), hospital stay, and mobilization time. Data were analyzed using independent t-tests, Chi-square tests, and stratified subgroup analyses, with significance set at p<0.05. Results: Baseline demographic and clinical characteristics were comparable between groups (p>0.05). The mean operative time was significantly shorter in the MISS group (82.4 ± 14.8 min) compared to the open group (93.7 ± 16.5 min, p=0.002). Postoperative pain scores were also lower in MISS (3.2 ± 0.9) versus open surgery (4.7 ± 1.1, p<0.001). Hospital stay was reduced in MISS patients (13.8 ± 2.7 days) compared to open surgery (15.9 ± 3.1 days, p=0.002). Mobilization occurred earlier in the MISS group (3.4 ± 1.2 days) than in the open group (4.8 ± 1.5 days, p<0.001). Subgroup analyses confirmed consistent benefits of MISS across most age, gender, and ASA strata. Conclusion: MISS demonstrated superiority over open stabilization in reducing operative time, postoperative pain, hospital stay, and mobilization delay in thoracolumbar traumatic spine fractures.
Downloads
References
1. Hofler, R. C., & O’Toole, J. E. (2022). Thoracolumbar spine fractures. Acute Care Neurosurgery by Case Management, 125-135.
https://doi.org/10.1007/978-3-030-99512-6_10
2. Gui, Q., Su, X., Lu, Z., & He, J. (2020). Comparison between minimally invasive percutaneously and open pedicle screw fixation of thoracolumbar fracture. Medicine, 99(49), e23403.
https://doi.org/10.1097/md.0000000000023403
3. Eiff MP, Hatch RL. Spine fractures. In: Fracture Management for Primary Care. 3rd ed. Philadelphia: Saunders; 2011. p. 187–213.
4. Sharif, S., Shaikh, Y., Yaman, O., & Zileli, M. (2021). Surgical techniques for thoracolumbar spine fractures: WFNS spine committee recommendations. Neurospine, 18(4), 667-680.
https://doi.org/10.14245/ns.2142206.253
5. Carazzo, C. A., Yurac, R., Guiroy, A., Zamorano, J. J., Cabrera, J. P., & Joaquim, A. F. (2021). Minimally invasive versus open surgery for the treatment of types B and C thoracolumbar injuries: A PRISMA systematic review. International Journal of Spine Surgery, 15(4), 803-810.
6. McAnany, S. J., Overley, S. C., Kim, J. S., Baird, E. O., Qureshi, S. A., & Anderson, P. A. (2015). Open versus minimally invasive fixation techniques for thoracolumbar trauma: A meta-analysis. Global Spine Journal, 6(2), 186-194.
https://doi.org/10.1055/s-0035-1554777
7. Xu, Y., Sun, Y., Shi, R., Li, J., Zhang, F., Guo, L., & Zhang, W. (2023). A clinical comparative study on percutaneous and open approaches for screw internal fixation in treating thoracolumbar fractures. Orthopaedic Surgery, 15(10), 2532-2539.
https://doi.org/10.1111/os.13825
8. Afolabi, A., Weir, T. B., Usmani, M. F., Camacho, J. E., Bruckner, J. J., Gopinath, R., Banagan, K. E., Koh, E. Y., Gelb, D. E., & Ludwig, S. C. (2020). Comparison of percutaneous minimally invasive versus open posterior spine surgery for fixation of thoracolumbar fractures: A retrospective matched cohort analysis. Journal of Orthopaedics, 18, 185-190.
https://doi.org/10.1016/j.jor.2019.11.047
9. Murans, G., Meska, L., Gaurilcikas, M., Jespersen, S. M., & Lindberg-Larsen, M. (2024). Patient-reported outcome from minimal invasive surgery compared with conventional open surgery for thoracolumbar fractures of the spine. Brain and Spine, 4, 102782.
https://doi.org/10.1016/j.bas.2024.102782
10. Kim, D., Lee, S., Chung, S. K., & Lee, H. (2005). Comparison of Multifidus muscle atrophy and trunk extension muscle strength. Spine, 30(1), 123-129.
https://doi.org/10.1097/01.brs.0000148999.21492.53
11. McAfee, P. C., Phillips, F. M., Andersson, G., Buvenenadran, A., Kim, C. W., Lauryssen, C., ... & Taylor, W. (2010). Minimally invasive spine surgery. Spine, 35(26S), S271-S273.
https://doi.org/10.1097/BRS.0b013e31820250a2
12. Li KK, Chung OM, Tang VL, Luk KD, Wong YW, Wong KC. Clinical and radiological outcomes of minimally invasive versus open posterior spinal fixation for thoracolumbar fractures. Spine J. 2016;16(8):1022–9.
13. Phan, K., Rao, P. J., & Mobbs, R. J. (2015). Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures: Systematic review and meta-analysis of comparative studies. Clinical Neurology and Neurosurgery, 135, 85-92.
https://doi.org/10.1016/j.clineuro.2015.05.016
14. Verlaan, J. J., Diekerhof, C. H., Buskens, E., Van der Tweel, I., Verbout, A. J., Dhert, W. J., & Oner, F. C. (2004). Surgical treatment of traumatic fractures of the thoracic and lumbar spine. Spine, 29(7), 803-814.
https://doi.org/10.1097/01.brs.0000116990.31984.a9
15. Paterakis K, Karantanas AH, Hadjipavlou AG. Thoracolumbar fractures: Minimally invasive versus open stabilization. Eur Spine J. 2020;29(3):503–12.
16. Versteeg AL, Verlaan JJ, de Bie RA, Oner FC. Clinical outcome of minimally invasive versus open posterior fixation of traumatic thoracolumbar fractures: A systematic review and meta-analysis. Eur Spine J. 2018;27(4):849–59.
17. Fan SW, Hu ZJ, Fang XQ, Zhao FD, Huang Y, Yu HJ. Comparison of paraspinal muscle injury in one-level thoracolumbar fracture: Percutaneous versus open pedicle screw fixation. Spine. 2010;35(12):E496–502.
18. Bindal, R. K., Glaze, S., Ognoskie, M., Tunner, V., Malone, R., & Ghosh, S. (2008). Surgeon and patient radiation exposure in minimally invasive transforaminal lumbar interbody fusion. Journal of Neurosurgery: Spine, 9(6), 570-573.
https://doi.org/10.3171/spi.2008.4.08182
19. Schwendner M, Manner J, Ruffing S, Buhren V, Grützner PA, Franke J. Long-term outcomes of minimally invasive versus open posterior stabilization in thoracolumbar fractures. Eur J Trauma Emerg Surg. 2021;47(6):1873–80.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
