Percutaneous versus open technique transpedicular fixation in patients with thoracolumbares type A fractures

INTRODUCCION: Las tecnicas de fijacion transpedicular percutanea son una herramienta emergente en el tratamiento del trauma espinal, sin embargo, su uso no es totalmente aceptado. OBJECTIVE: Compare results in patients with traumatic vertebral fracture, treated with percutaneous transpedicular fixation surgery versus open transpedicular fixation. MATERIAL AND METHODS: From January to December 2016, 15 patients with traumatic vertebral fracture were randomly divided into 2 groups, group A were six treated with percutaneous transpedicular fixation, group B were treated with open technique transpedicular fixation, three patients were eliminated. Transoperative bleeding, postoperative pain with the 24-hour and two-week postoperative visual scale, the six-week Oswestry lumbar pain disability index, and three, six, 12 and 24 months of postoperative control were evaluated. RESULTADO: El seguimiento fue de 24 meses. Se reportaron diferencias estadisticamente significativas en el sangrado transoperatorio (p 2.43E-05), EVA al primer dia (p 0.0003), EVA a las dos semanas (p = 0.01); tambien en el cuestionario de discapacidad de dolor lumbar Oswestry a las seis semanas (p = 0.0007), tres meses (p = 0.005), seis meses (p = 0.005), 12 meses (p = 0.01) y 24 meses (p = 0.004). No se observaron diferencias significativas con respecto al tiempo operatorio (p = 0.12). DISCUSION: En nuestro trabajo encontramos que el sangrado transoperatorio, dolor postoperatorio y discapacidad funcional son significativamente menores en el grupo de fijacion transpedicular percutanea.