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Research ArticleMinimally Invasive Surgery

Minimally Invasive Versus Open Surgery for the Treatment of Types B and C Thoracolumbar Injuries: A PRISMA Systematic Review

Charles André Carazzo, Ratko Yurac, Alfredo Guiroy, Juan J. Zamorano, Juan P. Cabrera, Andrei F. Joaquim and AO Spine Latin America Trauma Study Group
International Journal of Spine Surgery July 2021, 8103; DOI: https://doi.org/10.14444/8103
Charles André Carazzo
1University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
MD, MSC
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Ratko Yurac
2Department of Orthopedics and Traumatology, University del Desarrollo, Santiago, Chile
3Spine Unit, Department of Traumatology, Clínica Alemana, Santiago, Chile
MD
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Alfredo Guiroy
4Spine Unit, Orthopedics Department, Hospital Español de Mendoza, Mendoza, Argentina
MD
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Juan J. Zamorano
2Department of Orthopedics and Traumatology, University del Desarrollo, Santiago, Chile
3Spine Unit, Department of Traumatology, Clínica Alemana, Santiago, Chile
MD
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Juan P. Cabrera
5Department of Neurosurgery, Hospital Clínico Regional de Concepción, Concepción,Chile
MD
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Andrei F. Joaquim
6Department of Neurosurgery, University of Campinas, Campinas, SãoPaulo, Brazil
MD, PHD
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ABSTRACT

Background Thoracic and lumbar spine injuries may require surgical management, particularly AO Spine types B and C injuries. Open reduction and fixation using pedicle screws, with or without fusion and/or decompression, is the gold standard surgical treatment for unstable injuries. Recent advances in instrumentation design have resulted in less-invasive surgeries. However, the literature is sparse about the effectiveness of these procedures for types B and C injuries. The objective is to compare the outcomes of conventional open surgery versus minimally invasive spine surgery (MISS) for the treatment of AO Spine types B and C thoracolumbar injuries.

Methods A systematic review of published literature in PubMed, Web of Science, and Scopus was performed to identify studies comparing outcomes achieved with open versus minimally invasive surgery in AO Spine types B and C thoracolumbar injury patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used.

Results Five retrospective case-control studies and 3 prospective studies met selection criteria. In general, most of the studies demonstrated that minimally invasive spine surgery is feasible for types B and C injuries, and associated with potential advantages like reduced blood loss, postoperative pain, and muscle injury, and shorter hospital stays. However, no differences were detected in major outcomes, like neurological status or disability.

Conclusions Published literature currently suggests that minimally invasive spine surgery is a valid alternative for treating types B and C thoracolumbar injuries. However, further comparative prospective randomized clinical trials are necessary to establish the superiority of one approach over the other.

Level of Evidence 3

Footnotes

  • Disclosures and COI: The authors have declared no conflicting interest.

  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Minimally Invasive Versus Open Surgery for the Treatment of Types B and C Thoracolumbar Injuries: A PRISMA Systematic Review
Charles André Carazzo, Ratko Yurac, Alfredo Guiroy, Juan J. Zamorano, Juan P. Cabrera, Andrei F. Joaquim, AO Spine Latin America Trauma Study Group
International Journal of Spine Surgery Jul 2021, 8103; DOI: 10.14444/8103

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Minimally Invasive Versus Open Surgery for the Treatment of Types B and C Thoracolumbar Injuries: A PRISMA Systematic Review
Charles André Carazzo, Ratko Yurac, Alfredo Guiroy, Juan J. Zamorano, Juan P. Cabrera, Andrei F. Joaquim, AO Spine Latin America Trauma Study Group
International Journal of Spine Surgery Jul 2021, 8103; DOI: 10.14444/8103
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