Comparison of minimally invasive percutaneous and conventional open pedicle screw fixation for thoracolumbar fractures: a meta-analysis

doi:10.3969/j.issn.2095-4344.2016.13.019

Abstract

Abstract:

BACKGROUND: Open reduction pedicle screw fixation for thoracolumbar fracture could obtain satisfactory effects, and has been extensively used. However, it has potential risk during and after repair. Minimally invasive percutaneous pedicle screw technique minimizes the trauma and complications of soft tissue. It remains poorly understood which is better minimally invasive percutaneous or conventional open pedicle screw fixation for the repair of thoracolumbar fracture.
OBJECTIVE: To perform quality evaluation and meta-analysis on curative effect and postoperative complications of minimally invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures.
METHODS: A detailed search of several electronic databases, including Cochrane Library, PubMed, WanFang, CNKI, VIP and CBM, was undertaken. Simultaneously, Chinese Journal of Orthopaedics, Chinese Journal of Orthopaedic Trauma, and Chinese Journal of Trauma were checked by hand to identify controlled trials regarding minimally invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures published from inception to 2015, and the references of the included studies were checked. According to inclusion and exclusion criteria, references were screened, data were extracted and quality was evaluated by four investigators independently. Meta-analysis was conducted using RevMan 5.2 software. The quality of references of the included controlled trials was assessed with CONSORT statement and some surgery clinical evaluation indexes.
RESULTS AND CONCLUSION: We included 28 studies, including 25 randomized controlled trials/quasi-randomized controlled trials and 3 retrospective comparative studies, with 1 285 patients. Meta-analysis results demonstrated that compared with the conventional open pedicle screw, minimally invasive percutaneous pedicle screw fixation could significantly reduce operation time, blood loss, hospital stays, postoperative complication rate and height loss (P < 0.05). No significant difference in postoperative pain grade was detected between them (P > 0.05). These results indicate that minimally invasive percutaneous pedicle screw fixation for thoracolumbar fracture was safe and reliable, had small trauma, less blood loss, rapid recovery, short hospital stay, and less postoperative complications. Nevertheless, methods and results of most studies are not detailed enough. We suggested reporting randomized controlled trials according to related standards in order to improve the report quality and authenticity of randomized controlled trials.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Xue Wen, Liu Shu-rao, Guan Xiao-li, Wang Zeng-ping, Kang Zhong-ren, Zhou Hui-ru, Liu Lin, Qian Rao-wen. Comparison of minimally invasive percutaneous and conventional open pedicle screw fixation for thoracolumbar fractures: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(13): 1961-1969.

Figures/Tables 8

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