Comparative Outcomes of Percutaneous and Conventional Open Pedicle Screw Fixation for Single-level Thoracolumbar Spine Injury: Randomised Controlled Trial

Introduction:To compare post-operative outcomes of percutaneous pedicle screw fixation (PPSF) vs open pedicle screw fixation (OPSF) in patients with thoracolumbar spine fractures with no neurological deficits.Materials and methods: In a randomised controlled trial, patients received short-segment fixation with intermediate screws.We assessed post-operative back pain (Visual Analog Scale or VAS), blood loss, operative/fluoroscopy times, radiographic parameters, and oswestry disability index (ODI) scores at 1, 2, 3, 6, 9, and 12 months.Results: Between January 2018 and October 2019, 31 patients received PPSF and 30 OPSF.Mean intra-operative blood loss was 66.45 (±44.29)ml for PPSF vs 184.83 (±128.36)ml for OPSF (p<0.001).Fluoroscopy time averaged 2.36 (±0.76) minutes for PPSF vs 0.58 (±0.51) minutes for OPSF (p<0.001).No significant differences existed in operative time or post-operative VAS scores.Radiographic parameters (kyphosis angle and vertebral height ratios) didn't significantly differ post-operatively or at 12 months.However, ODI scores differed significantly at 6 months (p=0.025), with no difference at 12 months.Conclusion: In this trial, PPSF was comparable to OPSF in improving ODI scores at 12 months but showed earlier improvement at 6 months and reduced blood loss.Radiographic outcomes remained similar between groups over 12 months.