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 meta-analysis 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.

Keywords: Percutaneous pedicle screw fixation; meta-analysis; open pedicle screw internal fixation; thoracic vertebral fractures.