Unilateral biportal endoscopy combined with percutaneous pedicle screw fixation for the treatment of thoracolumbar burst fractures:observation of short-term efficacy

Zhang Zhiyu; Lin Kexin; Yang Hanxiang; Lei Fuhao; Yu Yang

doi:10.3969/j.issn.1009-4237.2025.09.007

Abstract：Objective To investigate the efficacy of unilateral biportal endoscopy(UBE)combined with percutaneous pedicle screw fixation(PPF)in the treatment of thoracolumbar burst fractures.Methods A retro-spective analysis was conducted on 44 patients with single-segment thoracolumbar burst fractures combined with neu-rological injuries treated at our department from May 2021 to Jul.2023.This cohort included 26 males and 18 fe-males,aged 19-72(mean 46.3)years.Based on surgical approaches,patients were divided into two groups:19 cases were treated with UBE decompression combined with PPF(UBE group),and 25 cases were treated with open de-compression and PPF(open group).Comparisons were made between the two groups regarding operation time,intr-aoperative blood loss,and surgery-related complications.Preoperative,postoperative1-week,and final follow-up data were recorded,including visual analog scale(VAS)scores,American Spinal Injury Association(ASIA)grading,Oswestry disability index(ODI),radiographic and CT assessments of fracture healing,anterior vertebral height ratio,Cobb angle,and spinal canal occupancy rate.Results All the patients underwent surgery uneventfully,with no wound infections,worsened postoperative muscle weakness,or complications such as epidural hematoma.Primary wound healing was achieved in all patients.Operation time showed no statistically significant difference between the UBE and open groups(P>0.05).But the UBE group had significantly less intraoperative blood loss(mL,90.7±13.8 vs.128.8±11.3,P<0.05)and much lower VAS score(4.2±0.7 vs.4.9±1.2)and ODI(34.40%±7.40%vs.40.28%±7.17%)at 1 week postoperatively(both P<0.05),which were significantly improved at last follow-up for both UBE and open groups.The ASIA grades,anterior vertebral height ratio,Cobb angle,and spinal canal occu-pancy rate revealed no significant difference at all three time points between the two groups(all P>0.05).Conclu-sion UBE spinal canal decompression combined with PPF is safe and effective for managing thoracolumbar burst fractures.It can effectively relieve dural and nerve compression,restore spinal canal space,and maintain spinal align-ment and stability.Compared to open decompression,this method is less invasive and results in less intraoperative blood loss.