Percutaneous versus traditional fixation for fracture patients with Ankylosing spinal disorders: a meta-analysis

With the advancement of surgical technology and the refinement of minimally invasive techniques, the emergence of novel technologies has exerted a discernible impact on conventional approaches. Currently, percutaneous internal fixation guided by X-ray fluoroscopy has been employed in patients with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis, presenting a challenge to traditional open surgery. Our objective was to conduct a comprehensive literature review aiming to evaluate the potential surgical advantages associated with percutaneous internal fixation. The databases PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure were systematically searched to identify both randomized and nonrandomized studies focusing on fracture patients with ankylosing spinal disorders. The analysis included 10 studies comparing clinical indexes. Percutaneous internal fixation technology demonstrated overall feasibility in terms of operative time, intraoperative blood loss, postoperative bed rest duration, hospitalization duration, and complications (P < 0.05). However, there were no significant differences between the 2 groups in visual analog scale score, MacNab score, Cobb angle of injured segment, and vertebral height at 6 months and 1 year after operation (P > 0.05). Based on the current evidence, percutaneous internal fixation demonstrates clear advantages over open internal fixation. However, considering the limited quality of some studies, it is imperative to conduct additional high-quality randomized controlled trials to further validate these findings.