Percutaneous versus traditional open approaches for the treatment of thoracolumbar fractures in patients without neurologic deficits: a meta-analysis of 35 cohort studies.

Mingjiang Luo, Yuxin Yang, Zhixuan Liu, Jiayi Tan, Jiahui Luo, Zifan Long, Miaojue Chen, Can Liang, Zhihong Xiao

Abstract readMeta-AnalysisSystematic Review

In one paragraph

Synthesis in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it

0cells of the map it votes in

3citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

[Percutaneous Stabilization of the Thoracolumbar Spine: Indications, Limitations and Cohort Analysis].Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca · 2026
Article
Comparison of short- and long-term efficacy between percutaneous and open pedicle screw fixation for thoracolumbar vertebral fracture.American journal of translational research · 2026
Article
A More Efficient and Safer Improved Percutaneous Pedicle Screw Insertion Technique-Trajectory Dynamic Adjustment Technique, Technical Note, and Clinical Efficacy.Orthopaedic surgery · 2025
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mingjiang LuoDepartment of Spinal Surgery, Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421000, Hunan, China.

Yuxin YangHengyang Medical School, University of South China, Hengyang, Hunan, China.

Zhixuan LiuDepartment of Orthopedic Trauma, Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China.

Jiayi TanHengyang Medical School, University of South China, Hengyang, Hunan, China.

Jiahui LuoHengyang Medical School, University of South China, Hengyang, Hunan, China.

Zifan LongHengyang Medical School, University of South China, Hengyang, Hunan, China.

Miaojue ChenHengyang Medical School, University of South China, Hengyang, Hunan, China.

Can LiangHengyang Medical School, University of South China, Hengyang, Hunan, China.

Zhihong XiaoDepartment of Spinal Surgery, Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421000, Hunan, China. 35042875@qq.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

At present, percutaneous surgery is widely used to treat thoracolumbar fractures. However, the actual safety, feasibility, and effectiveness of percutaneous surgery are not clear. Through systematic review and meta-analysis, we compared the efficacies of percutaneous pedicle screw fixation and open pedicle screw fixation in the treatment of thoracolumbar fractures without nerve root symptoms. We systematically searched the PubMed, Embase, and Cochrane libraries for articles published on or before June 2023. All results were evaluated by standard methods recommended for meta-analysis, continuous data were expressed by standard mean differences (SMDs), and binary variables were analyzed by odds ratios (ORs) and 95% confidence intervals (95% CIs). We also explored the main sources of heterogeneity and the stability of the results through sensitivity analysis, Begg's funnel plots, and Egger's test. Thirty-five cohort studies with a total of 3039 patients were included. The study found that patients who undergo percutaneous approaches have less intraoperative blood loss (IBL), shorter length of hospital stay (LOS), shorter operation time, and shorter incision. Moreover, percutaneous approaches had more advantages in terms of visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and infection rates. However, there was no significant difference in anterior vertebral body height (AVB), Cobb angle (CA), or screw errors between the two groups. In the long run, the clinical and surgical results of the percutaneous approach are better than those of the open approach, but the radiological results of both operations do not seem to show an advantage for any specific approach. Because of publication bias and heterogeneity, our findings must be interpreted with caution. However, this paper will provide some support for clinicians to choose suitable surgical methods for the treatment of thoracolumbar fractures.

Indexed as

Blood Loss, SurgicalPedicle ScrewsCohort StudiesHumansLength of StayOdds RatioMeta-analysis and cohort studiesPercutaneousThoracolumbar fracturesTraditional open approaches

Identifiers

PMID38263482

DOI10.1007/s10143-023-02259-y

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.