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Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis

Study Design Systematic literature review and meta-analysis of studies published in English. Objective This study evaluated differences in outcome variables between percutaneous and open pedicle screws for traumatic thoracolumbar fractures. Methods A systematic review of PubMed, Cochrane, and Embase...

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Detalles Bibliográficos
Autores principales: McAnany, Steven J., Overley, Samuel C., Kim, Jun S., Baird, Evan O., Qureshi, Sheeraz A., Anderson, Paul A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771513/
https://www.ncbi.nlm.nih.gov/pubmed/26933621
http://dx.doi.org/10.1055/s-0035-1554777
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author McAnany, Steven J.
Overley, Samuel C.
Kim, Jun S.
Baird, Evan O.
Qureshi, Sheeraz A.
Anderson, Paul A.
author_facet McAnany, Steven J.
Overley, Samuel C.
Kim, Jun S.
Baird, Evan O.
Qureshi, Sheeraz A.
Anderson, Paul A.
author_sort McAnany, Steven J.
collection PubMed
description Study Design Systematic literature review and meta-analysis of studies published in English. Objective This study evaluated differences in outcome variables between percutaneous and open pedicle screws for traumatic thoracolumbar fractures. Methods A systematic review of PubMed, Cochrane, and Embase was performed. The variables of interest included postoperative visual analog scale (VAS) pain score, kyphosis angle, and vertebral body height, as well as intraoperative blood loss and operative time. The results were pooled by calculating the effect size based on the standardized difference in means. The studies were weighted by the inverse of the variance, which included both within- and between-study error. Confidence intervals were reported at 95%. Heterogeneity was assessed using the Q statistic and I (2). Results After two-reviewer assessment, 38 studies were eliminated. Six studies were found to meet inclusion criteria and were included in the meta-analysis. The combined effect size was found to be in favor of percutaneous fixation for blood loss and operative time (p < 0.05); however, there were no differences in vertebral body height (VBH), kyphosis angle, or VAS scores between open and percutaneous fixation. All of the studies demonstrated relative homogeneity, with I (2) < 25. Conclusions Patients with thoracolumbar fractures can be effectively managed with percutaneous or open pedicle screw placement. There are no differences in VBH, kyphosis angle, or VAS between the two groups. Blood loss and operative time were decreased in the percutaneous group, which may represent a potential benefit, particularly in the polytraumatized patient. All variables in this study demonstrated near-perfect homogeneity, and the effect is likely close to the true effect.
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spelling pubmed-47715132016-03-01 Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis McAnany, Steven J. Overley, Samuel C. Kim, Jun S. Baird, Evan O. Qureshi, Sheeraz A. Anderson, Paul A. Global Spine J Article Study Design Systematic literature review and meta-analysis of studies published in English. Objective This study evaluated differences in outcome variables between percutaneous and open pedicle screws for traumatic thoracolumbar fractures. Methods A systematic review of PubMed, Cochrane, and Embase was performed. The variables of interest included postoperative visual analog scale (VAS) pain score, kyphosis angle, and vertebral body height, as well as intraoperative blood loss and operative time. The results were pooled by calculating the effect size based on the standardized difference in means. The studies were weighted by the inverse of the variance, which included both within- and between-study error. Confidence intervals were reported at 95%. Heterogeneity was assessed using the Q statistic and I (2). Results After two-reviewer assessment, 38 studies were eliminated. Six studies were found to meet inclusion criteria and were included in the meta-analysis. The combined effect size was found to be in favor of percutaneous fixation for blood loss and operative time (p < 0.05); however, there were no differences in vertebral body height (VBH), kyphosis angle, or VAS scores between open and percutaneous fixation. All of the studies demonstrated relative homogeneity, with I (2) < 25. Conclusions Patients with thoracolumbar fractures can be effectively managed with percutaneous or open pedicle screw placement. There are no differences in VBH, kyphosis angle, or VAS between the two groups. Blood loss and operative time were decreased in the percutaneous group, which may represent a potential benefit, particularly in the polytraumatized patient. All variables in this study demonstrated near-perfect homogeneity, and the effect is likely close to the true effect. Georg Thieme Verlag KG 2015-06-05 2016-03 /pmc/articles/PMC4771513/ /pubmed/26933621 http://dx.doi.org/10.1055/s-0035-1554777 Text en © Thieme Medical Publishers
spellingShingle Article
McAnany, Steven J.
Overley, Samuel C.
Kim, Jun S.
Baird, Evan O.
Qureshi, Sheeraz A.
Anderson, Paul A.
Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
title Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
title_full Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
title_fullStr Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
title_full_unstemmed Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
title_short Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis
title_sort open versus minimally invasive fixation techniques for thoracolumbar trauma: a meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771513/
https://www.ncbi.nlm.nih.gov/pubmed/26933621
http://dx.doi.org/10.1055/s-0035-1554777
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