Examining the Postoperative Outcomes After Minimally Invasive Versus Open Fixation of Thoracolumbar Fractures in Patients With Ankylosing Spondylitis: A Systematic Review and Meta-analysis.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2026-08-01 Epub Date: 2025-09-01 DOI:10.1097/BSD.0000000000001925

Omkar S Anaspure, Shiv Patel, Andrew Newsom, Anthony N Baumann, Aryan S Anaspure, Susan M Goodman, Bella Mehta, Sravisht Iyer

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引用次数: 0

Abstract

Study design: Systematic Review and Meta-Analysis.

Objective: This review aims to evaluate medical complications, patient-reported outcomes, and bony healing, operative time, and blood loss after MIS versus open fixation for TL fractures in patients with AS.

Summary of background data: Ankylosing spondylitis (AS) causes spinal rigidity and increases the risk of vertebral fractures, especially in the thoracolumbar (TL) region. While pedicle screw fixation via percutaneous or open approaches is commonly used, evidence on the safety and bony healing outcomes specifically in AS patients is limited. This study evaluates medical complications, patient-reported outcomes, and bony healing after minimally invasive (MIS) versus open fixation in AS patients with TL fractures.

Methods: This systematic review and meta-analysis evaluated postoperative complications and clinical outcomes in patients with AS undergoing MIS or open fixation of TL fractures by querying PubMed, SCOPUS, CINAHL, and Web of Science, up to August 26, 2024.

Results: Nine comparative and 4 noncomparative studies (n=443; 77.16% male; mean age 70.74 ± 9.21 y; mean follow-up 24.27 ± 15.10 mo) were included. Bony healing was achieved in 98% (n=111) and 97.14% (n=35) of MIS and open fixation patients, respectively, which was not significantly different (P=0.978). However, MIS had a significantly shorter mean operative time (150.97 ± 50.96 vs. 251.43 ± 84.36 min; P<0.001), less blood loss (275.73 ± 100 vs. 856.44 ± 294.91 mL; P=0.016) and shorter hospital stay (17.68 ± 10.93 d vs. 32.44 ± 13.58 d; P<0.001) compared with open fixation, respectively. Revision surgery was necessitated in 1.39% (n=1) of MIS patients and in 8% (n=4) of open fixation patients, which was not found to be significantly different (P=0.135).

Conclusions: Percutaneous MIS instrumented fixation for TL fractures in patients with AS is viable, affording comparable bony healing, reduced blood loss, operative time, and hospital stay compared to traditional open fixation.

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检查强直性脊柱炎患者胸腰椎骨折微创与开放式固定的术后结果：系统回顾和荟萃分析。

研究设计：系统评价和荟萃分析。目的：本综述旨在评估AS患者行MIS与开放式固定治疗TL骨折后的医疗并发症、患者报告的结果、骨愈合、手术时间和出血量。背景资料总结：强直性脊柱炎（AS）导致脊柱僵硬，增加椎体骨折的风险，特别是在胸腰椎（TL）区域。虽然经皮或开放入路椎弓根螺钉固定是常用的方法，但关于AS患者的安全性和骨愈合结果的证据有限。本研究评估了AS合并TL骨折患者的医疗并发症、患者报告的结果以及微创（MIS）与开放式固定后的骨愈合情况。方法：本系统综述和荟萃分析通过查询PubMed、SCOPUS、CINAHL和Web of Science截止到2024年8月26日，评估AS患者行MIS或开放内固定治疗TL骨折的术后并发症和临床结果。结果：纳入9项比较研究和4项非比较研究（n=443，男性77.16%，平均年龄70.74±9.21岁，平均随访24.27±15.10个月）。MIS与开放式固定患者的骨愈合率分别为98% （n=111）和97.14% (n=35)，差异无统计学意义（P=0.978）。然而，MIS的平均手术时间明显缩短（150.97±50.96分钟vs 251.43±84.36分钟）。结论：与传统的开放式固定相比，经皮MIS固定治疗AS患者TL骨折是可行的，可提供相当的骨愈合，减少出血量，手术时间和住院时间。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.