Outcomes of Thoracolumbar Burst Fractures Treated With Open Versus Minimally Invasive Percutaneous Posterior Spinal Stabilization: A Retrospective Study at a Rural Teaching Hospital in South India

Background Thoracolumbar spine fractures are the most prevalent type of axial skeleton fractures, with approximately two-thirds occurring between T11 and L2. Percutaneous pedicle screw fixation has been reported to be an effective treatment for thoracolumbar fractures. Minimally invasive percutaneous pedicle screw fixation yields outcomes comparable to those of the standard open procedure and has the advantages of less stress, bleeding, and pain, as well as rapid postoperative recovery. The main objective of this research was to compare the clinical and radiological outcomes of two surgical approaches (open and percutaneous posterior spinal stabilization), concentrating on nonosteoporotic AO Spine Type A3 thoracolumbar burst fractures between T11 and L2. Materials and methods We conducted a retrospective study in our hospital, where cases of thoracolumbar burst fractures meeting the inclusion criteria were chosen retrospectively from April 2022 to March 2023. A total of 54 patients (aged 18-60 years) who underwent spinal stabilization were included in this investigation. The population was divided into two cohorts, with 27 patients in each: Group A underwent open posterior spinal stabilization, and Group B underwent percutaneous posterior spinal stabilization. Data retrieved from medical records were analyzed with at least a six-month follow-up, mainly assessing the demographic data, intraoperative parameters, duration of hospitalization, clinical outcomes (Visual Analog Scale, Oswestry Disability Index, and McGill Pain Questionnaire scores), and radiological outcomes (vertebral wedge angle and correction loss). Results Both groups had a male preponderance. There were statistically meaningful distinctions between both groups regarding intraoperative parameters (blood loss and surgical duration) and primary clinical outcome parameters (Visual Analog Scale, Oswestry Disability Index, and McGill Pain Questionnaire scores) in the early phase of the study. However, there were no statistically significant differences concerning radiological parameters (vertebral wedge angle and correction loss) or primary clinical outcome parameters at the last follow-up. Conclusion The treatment modalities (open and percutaneous posterior spinal stabilization surgery) were equally safe and effective. However, the percutaneous group demonstrated significant reductions in the length of the surgical procedure, blood loss during surgery, duration of hospital stay, and immediate postoperative pain scores, all of which could potentially benefit patients.