The Role of Minimally Invasive Techniques in the Treatment of Thoracolumbar Trauma

Context: Thoracolumbar injuries are common manifestations of spinal trauma. While non-operative therapy is indicated in certain cases of isolated injury, operative therapy via open approaches are widely utilized. Recently, minimally invasive surgical (MIS) approaches have been adapted for the management of thoracolumbar trauma in an effort to avoid the operative morbidity of open thoracolumbar procedures. Purpose: The purpose of this review is to perform a critical analysis of the literature regarding the clinical efficacy and safety of MIS procedures in the management of thoracolumbar trauma. Evidence Acquisition: PubMed and MEDLINE databases were searched for articles published on the topic of MIS treatment of traumatic thoracolumbar injuries. Studies included in this review were comprised of clinical case series, retrospective cohort studies, non-randomized prospective cohort studies, prospective randomized controlled trials, and meta-analyses. Results: The majority of published studies were retrospective clinical case series comprising level IV evidence. The majority of studies demonstrated the viability of MIS approaches as a treatment modality for thoracolumbar trauma in regards to clinical outcomes, radiographic outcomes, and complication rates. Additionally, MIS procedures were associated with reductions in operative time, intraoperative blood loss, and immediate postoperative pain. Conclusions: MIS approaches to thoracolumbar trauma are viable treatment strategies in regards to clinical efficacy and safety. While the results for MIS procedures are promising, more high-quality prospective studies are necessary in order to make definitive conclusions regarding the superiority of MIS over open surgical strategies