Comparison of the clinical efficacy of Wiltse paraspinal approach and O-arm navigation for the treatment of thoracolumbar fractures

Abstract Background To evaluate the clinical efficacy of Wiltse paraspinal approach and percutaneous pedicle screw placement under O-arm navigation for the treatment of thoracolumbar fracture.Methods We enrolled a total of 54 patients with neurologically intact thoracolumbar fracture that received minimally invasive technology. Among these, 28 cases were treated with pedicle screw fixation through Wiltse paraspinal approach (WPSF), and another 26 cases were received percutaneous pedicle screws fixation under O-arm navigation (OPSF). The statistical methods were used to performing a detailed comparison of clinical outcomes, radiologic findings and complications between the two groups at pre-op, post-op and last follow-up.Results There were no significant differences between the two groups among intraoperative bleeding, length of incision, postoperative hospitalization times and accuracy rate of pedicle screw placement (p>0.05). Visual analog scale (VAS) scores, Oswestry disability in­dex (ODI) scores, local Cobb angle (LCA), vertebral wedge angle (VWA) and R value were obviously improved after surgery, though no clear discrepancy between the groups at each time point (p>0.05). However, the OPSF group had longer operation time and higher surgical expenditure than the WPSF group (p<0.05).Conclusions Both WPSF and OPSF were safe and effective for the treatment of thoracolumbar fracture. Although the two groups showed favorable clinical and radiologic outcomes till the final follow-up, we recommended the minimally invasive technology of WPSF considering the lower duration of surgery and medical costs. A randomized controlled study of high-quality and large sample required to prove our findings in the future.