Meta-analysis Of The Efficacy Of Percutaneous Pedicle Screw Fixation And Posterior Open Pedicle Screw Fixation For Thoracolumbar Spinal Fractures

Objective: The clinical efficacy and safety of percutaneous minimally invasive and posterior open pedicle screw internal fixation for treating spinal thoracolumbar fracture were analyzed.Methods: Percutaneous minimally invasive and posterior open pedicle screw internal fixation for treating spinal thoracolumbar fracture from 2011 to January 2020 in databases such as CNKI,Sino Med,Wan Fang Data,VIP,Cochrane Collaboration Library,Medline and Pub Med searched by computer for random control trials.The literature was screened according to the inclusion criteria.Meta-analysis was performed on the indicators such as postoperative complications,VAS pain score,length of hospital stays,intraoperative blood loss and operative time with the help of Rev Man 5.3.Results: Eight case-control trials were selected in total,with a total of 558 cases.Meta results showed that the The difference of operation duration was statistically significant [SMD =-0.71,95% CI(-0.13,-0.39),P<0.0001];The difference of intraoperative blood loss was statistically significant [SMD =-1.30,95% CI(-1.59,-1.00),P<0.00001];The difference of VAS scores was statistically significant [SMD =-1.70,95% CI(-1.97,-1.44),P<0.00001];There was significant difference in the improvement of hospital stay [MD = 1.21,95% CI(-1.78,-0.63),P<0.0001;There was significant difference in the incidence of complications[OR=0.25,95% CI(0.11,0.59),P=0.002].Conclusions: Comparing the cases collected in this study,we found that compared with the posterior open surgery,the minimally invasive surgery had shorter operation time,less bleeding,lower VAS score,greater improvement of hospital stay,less complications,and the difference was statistically significant.