Comparison of Outcomes between Minimal Invasive Spine Stabilization and Open Conventional Approach in Thoracolumbar Traumatic Spine Fractures

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Background: Thoracolumbar traumatic spine fractures represent one of the most frequent spinal injuries, often necessitating surgical stabilization. While open conventional fixation has been the established method, minimally invasive spine stabilization (MISS) has gained attention due to its potential advantages in reducing surgical morbidity. This study aimed to compare outcomes between MISS and the open conventional approach in patients with thoracolumbar traumatic fractures. Methods: A quasi-experimental study was conducted in the Department of Neurosurgery, Sheikh Zayed Hospital, Rahim Yar Khan, from January to May 2025. Seventy-six patients meeting eligibility criteria were enrolled and equally assigned to MISS or open conventional fixation groups (38 each). Outcomes assessed included operative time, postoperative pain (Numerical Rating Scale, day seven), hospital stay, and mobilization time. Data were analyzed using independent t-tests, Chi-square tests, and stratified subgroup analyses, with significance set at p<0.05. Results: Baseline demographic and clinical characteristics were comparable between groups (p>0.05). The mean operative time was significantly shorter in the MISS group (82.4 ± 14.8 min) compared to the open group (93.7 ± 16.5 min, p=0.002). Postoperative pain scores were also lower in MISS (3.2 ± 0.9) versus open surgery (4.7 ± 1.1, p<0.001). Hospital stay was reduced in MISS patients (13.8 ± 2.7 days) compared to open surgery (15.9 ± 3.1 days, p=0.002). Mobilization occurred earlier in the MISS group (3.4 ± 1.2 days) than in the open group (4.8 ± 1.5 days, p<0.001). Subgroup analyses confirmed consistent benefits of MISS across most age, gender, and ASA strata. Conclusion: MISS demonstrated superiority over open stabilization in reducing operative time, postoperative pain, hospital stay, and mobilization delay in thoracolumbar traumatic spine fractures.

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