From Open to MIS, evolving practice for posterior approaches in high-energy thoracolumbar vertebral fractures: a retrospective cohort study

Introduction thoracolumbar fractures often require fixation. Minimally invasive surgery (MIS), including Wiltse and percutaneous techniques, aims to reduce morbidity compared to open surgery. Research question to evaluate multidimensional outcomes in high-energy thoracolumbar fractures treated via MIS versus open surgery. Methods a single-centre retrospective cohort study including 82 neurologically intact adults (43.2±18.5y) who underwent open or MIS posterior fixation. Patients were divided into the Open ( n =23), versus MIS Wiltse ( n =30) and Percutaneous ( n =29) cohorts. The primary outcome was length of stay. Secondary outcomes included intraoperative blood loss, radiographic correction, second-stage surgery, concomitant kyphoplasty, pain and return-to-work status. Results Length of stay was reduced for Wiltse (11.2±4.5 d , p