STUDY DESIGN: A prospective clinical study. OBJECTIVE: To evaluate whether a percutaneous dorsal instrumentation of thoracolumbar @entity174 prevents @entity16 to the spinal muscles. METHODS: A total of 57 @entity1 with thoracolumbar @entity174 (Th12-L4) were divided into two groups, comparable in terms of gender, fracture level, classification and surgical concept. In the first, 24/57 @entity1 were treated using an open procedure (OP-G); in the second, 33/57 were treated via percutaneous dorsal instrumentation (PER-G). @entity174 localisation and classification, accuracy of pedicle screw placement, perioperative @entity190 , OR- and image converter time as well as @entity121 (needle-EMG) were evaluated. RESULTS: OR- and image converter time as well as the accuracy of pedicle screw placement were not statistically different between groups. The difference in perioperative @entity190 [43 (10-90) ml (PER-G) vs [870 (570-1,200 ml (OP-G)] was statistically significant (P <0.005). Needle EMG revealed no @entity121 , and the physiological activity and muscle potentials were normal (PER-G). In the OP-G, polyphasic EMG signals were most common (80%), a sign of the drop-out of numerous motor units. CONCLUSIONS: The open procedure caused permanent and significant damage to the strongest extensors of the autochthonus back musculature, the m. multifidus, which results from multisegment combined damage to the r. posterior nervi spinalis and muscle fibres. In contrast, percutaneous placement of an internal fixative reduces perioperative access morbidity causing little iatrogenic @entity121 and only a minor perioperative @entity190 .

[Percutaneous dorsal versus open instrumentation for XXXX . A comparative, prospective study].

@entity1 :: ('9606', 'Species') :: ['patients'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'Fracture'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity16 :: ('MESH:D009422', 'Disease') :: ['irreversible damage'] @entity121 :: ('MESH:D009135', 'Disease') :: ['muscle damage', 'damage to back muscles']
@entity174 :: (MESH:D050723,Disease) :: ['fractures of the thoracolumbar border']
