Effect of RTS versus percutaneous conventional pedicle screw fixation on type A thoracolumbar fractures: a retrospective cohort study

This study aims at evaluating the effects of RTS (rotation softened trauma fixation system) compared with PCPSF (percutaneous conventional pedicle screw fixation) on type A thoracolumbar fractures. In this retrospective cohort study, 116 patients with type A thoracolumbar fractures from March 2014 to June 2018 were enrolled. PCPSF was performed in 60 patients, meanwhile the other 56 patients accepted RTS. VAS scores, Cobb angle, anterior vertebral height (AVH) and perioperative data were compared between the two groups. Both groups were consistent with baseline on demographic and clinical characteristics. No significant difference was observed in VAS score between-group before and after operation. One year after surgery, the VAS score of RTS group was lower than that of PCPSF group (0.7 ± 0.3 vs. 1.5 ± 0.4). The postoperative AVH (%) in PCPSF was 82.3% (95%CI, 81.7–84.6), and 91.78% (95% CI, 91.1–92.4) in RTS. The postoperative improvement rate of AVH (%) in RTS was higher than that in PCPSF (30.6 ± 5.0 [95% CI, 29.2–32.0] vs. 22.0 ± 7.3 [95% CI, 20.2–24.2]). The postoperative Cobb angle (°) in PCPSF was 2.6 ± 3.4 (95%CI,11.7–13.5), and 7.5 ± 2.0 (95%CI,7.0–8.0) in RTS. The postoperative correction of Cobb angle (°) in RTS was higher than that in PCPSF (16.1 ± 3.8 95%CI,15.1–17.1] vs. 11.6 ± 5.2 95%CI,10.3–13.1]). Compared with PCPSF, RTS has advantages in restoring the anterior vertebral height and reducing local kyphosis.