The comparison of computer assisted minimally invasive spine surgery and traditional open treatment for thoracolumbar fractures / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the clinical results between computer assisted minimally invasive spine surgery (CAMISS) and traditional open fixation surgery which used in thoracolumbar fractures.</p><p><b>METHODS</b>A prospective randomized controlled trial of patients who had undergone surgery for thoracolumbar fracture from January 2006 to March 2011 was performed. The patients were randomly divided into CAMISS group and traditional open treatment group (control group) by random number table. Clinical results were assessed by comparing the following parameters between patients who had undergone CAMISS or traditional open surgery operative time, estimated blood loss, visual analogue scale (VAS) of the low back pain, the accuracy of pedicle screw, the status and the correction of kyphosis.</p><p><b>RESULTS</b>Forty-seven patients underwent CAMISS, and fifty patients underwent traditional open surgery. The follow-up periods were 3 - 50 months (mean 12 months). According to the preoperative data, the two groups did not differ with respect to age, gender, marriage, occupation, mechanism of injury, classification of fracture, preoperative VAS scores of the low back pain, preoperative functional spine unit (FSU) Cobb's angle and preoperative local angle of the fracture vertebral body (P > 0.05). Compare to the control group, the patients who got CAMISS had more accuracy of pedicle screw, less blood loss, short immobilized time, lower postoperative fever, and better VAS score of the low back pain (t = 2.162 - 8.736, P < 0.05). The improvement of FSU Cobb's angle and local angle of the fracture vertebral body were better at control group after operation (13.8° ± 6.8° vs. 10.9° ± 5.5°, 11.0° ± 6.0° vs. 7.7° ± 4.8°, t = 2.108 and 2.610, P < 0.05). But there was no significant difference of the FSU Cobb's angle, or local angle of the fracture vertebral body between the two groups at post-operation and follow-up (P > 0.05).</p><p><b>CONCLUSIONS</b>CAMISS has the characteristics of fewer traumas, less bleeding, faster recovery, high accuracy of pedicle screws. It has comparable vertebral deformity correction and fixation result of the traditional open operation.</p>