International Journal of Research in Orthopaedics | March-April 2021 | Vol 7 | Issue 2 Page 343 International Journal of Research in Orthopaedics Kumar R et al. Int J Res Orthop. 2021 Mar;7(2):343-350 http://www.ijoro.org Original Research Article Analysis of outcome of percutaneous versus open pedicle screw fixation in the treatment of thoraco-lumbar spine fractures: a prospective comparative study Raj Kumar 1 , Bhaskar Sarkar 1 *, Syed Ifthekar 2 , Samarth Mittal 2 , Pankaj Kandwal 2 , Quamar Azam 1 INTRODUCTION Fractures of the thoracic and lumbar vertebrae are quite common injuries among polytrauma patients, and nearly one-third of those patients have concomitant neural structure injury and variable neurologic deficit. 1 Almost 60% of spinal fractures occur within the thoracolumbar region, with 17% being burst fracture. 2,3 These injuries are painful and may impact quality of life resulting in prolong absence from work and chronic pain; thus, having significant socio-economic impact furthermore. 4 These injuries are usually resulting of high energy trauma like motorized vehicle accidents or falls from height and more common in men. Elderly people also are in danger for these fractures, because of weakened bone from osteoporosis. 5 ABSTRACT Background: Aim of the study was to evaluate the effectiveness between percutaneous and open pedicle screw fixation in the treatment of traumatic thoracolumbar burst fractures with spinal injury. Methods: A prospective comparative study including thirty patients with thoracolumbar burst fracture were equally divided into an open pedicle screw fixation (OPSF) group and a percutaneous pedicle screw fixation (PPSF) group. Demographic characteristics, clinical and radiological outcomes, and adverse events were assessed and compared between the 2 groups. Results: Demographic and clinical features including age, gender, fracture level, mechanism of injury and neurological status in both groups were not significantly different (all p>0.05). The PPSF group exhibits significantly lower operative time, intraoperative blood loss, and hospital stay compared with the OPSF group (all p<0.05). There was no significant difference in the sagittal Cobb′s angle (CA), fracture vertebral body angle (VBA), anterior vertebral body height (AVBH) on pre-operative, immediate post-operative and final follow up between the two surgical techniques (all p>0.05). Visual analogue scale (VAS) remarkably decreased in both groups after surgery but difference was not statically significant (p=0.808). Common postoperative complications in both groups were superficial infections, pressure ulcer and urinary tract infection (UTI) worsening. Hardware failure was seen only in one case of PPSF group. Conclusions: Patients with thoracolumbar burst fractures can be effectively managed with PPSF/OPSF. There were no significant differences in radiological and clinical outcomes and post-op complications between 2 groups but blood loss, operative time and hospitalization stay were less in percutaneous group, which may represent a potential benefit. Keywords: Thoraco-lumbar burst fracture, OPSF, PPSF, Prospective comparative study 1 Department of Orthopedics, Trauma Surgery and 2 Spine Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India Received: 18 December 2020 Accepted: 18 January 2021 *Correspondence: Dr. Bhaskar Sarkar, E-mail: drbhaskarsarkar@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20210628