Thoracolumbar burst fractures are high-energy vertebral injuries, which can be normally treated non-surgically and in rare cases, surgery is the option. Of the two known surgical treatments for these fractures, mini-open pedicle screw (MPS) fixation via the Wiltse method had effective outcomes (surgical duration, radiation exposure, facet joint violation, etc.) as comapared to percutaneous pedicle screw fixation, as shown from this study.

This randomized controlled trial compared the efficacy of MPS fixation via the Wiltse method and percutaneous pedicle screw (PPS) fixation for the management of  thoracolumbar burst fractures in young and middle-aged patients.

On the whole, 60 patients with thoracolumbar vertebrae fractures were divided into 2 groups: MPS group (30 patients with average age of 42.2±6.7 years) and PPS group (30 patients with average age of 43.0±6.9 years). The clinical efficacy; radiographic outcome and exposure; were distinguished between both the groups.

No substantial difference in the blood loss, hospital stay, postoperative VAS (Visual Analog scale) for back pain, and ODI (Oswestry Disability Index) was witnessed between both the groups. Compared to the PPS group, the vertebral body angle (VBA) and vertebral body height (VBH) were found to be remarkably better in the MPS group at the last follow-up.

Also, no substantial variation in the rate of accuracy of pedicle screw placement between the groups was depicted; however, PPS group had an elevated facet joint violation (FJV). A lower average radiation exposure dosage in the MPS group was found.

As concluded, both the treatments- MPS fixation via the Wiltse approach and PPS fixation were recognised as safe and effective in patients suffering from single-segment thoracolumbar vertebral fractures. However, out of the two, MPS fixation via Wiltse method seems to be a better option in view of the surgical duration, radiation exposure, VBH, VBA and FJV, VBH at the last follow-up.