Minimally Invasive Surgery for Traumatic Thoracolumbar Fractures: A Cross-Sectional Study of Spine Surgeons

Abstract

Objective: To describe the perceived feasibility of minimally invasive surgical treatment of thoracolumbar fractures among spine surgeons in Latin American centers.

Methods: This is a cross-sectional study on minimally invasive surgical treatment for unstable thoracolumbar fractures. We conducted an online survey of spine surgeons working in Latin American centers, administered between December 16, 2022 and January 15, 2023. A nonprobabilistic sample was selected (snowball sampling). A questionnaire was sent by email and other messaging applications.

Results: Data were extracted from 134 surgeons. The majority of the respondents were from Brazil (n = 30, 22.4%), Mexico (n = 24, 17.9%), Argentina (n = 22, 16.4%), and Chile (n = 15, 11.2%). Their mean age was 46.53 years (standard deviation, 9.7; range 31-67) and almost all were males (n = 128, 95.5%). Most respondents were orthopedists (n = 85, 63.4%) or neurosurgeons (n = 49, 36.9%). Most of the respondents (n = 110, 82.1%) reported at least some difficulty using minimally invasive techniques for thoracolumbar fractures. It should be noted that there were significant regional differences between the surgeons' responses (P = 0.017). Chilean surgeons reported better results than others.

Conclusion: Spinal surgeons from Latin American centers have identified challenges and obstacles to performing minimally invasive surgery for thoracolumbar trauma. The survey found that a majority of respondents experienced some level of difficulty, with regional variations. The most frequently reported difficulties were the high cost of the procedure, patient insurance restrictions, and long insurance approval times.

Keywords: Minimally invasive surgery; Spine trauma; Thoracolumbar fractures.