Spinopelvic Dissociation: Comparison of Outcomes ofPercutaneous versus Open Fixation Strategies

Spinopelvic dissociation injuries are historically treated with open reduction with or without decompressivelaminectomy. Recent technological advances have allowed for percutaneous fixation with indirect reduction. Herein, we evaluateoutcomes and complications between patients treated with open reduction versus percutaneous spinopelvic fixation.Methods.Retrospective review of patients undergoing spinopelvic fixation from a single, level one trauma center from 2012 to 2017.Patient information regarding demographics, associated injuries, and treatment outcome measures was recorded and analyzed.All fractures were classified via the AO Spine classification system.Results.Thirty-one spinopelvic dissociations were identified: 15treated with open and 16 with percutaneous techniques. The two treatment groups had similar preoperative characteristics includingspinopelvic parameters (pelvic incidence and lumbar lordosis). Compared to open reduction internal fixation, percutaneousfixation of spinopelvic dissociation resulted in statistically significantly lower blood loss (171 cc versus 538 cc;𝑝=0.0013). Therewere no significant differences in surgical site infections(𝑝=0.48)or operating room time(𝑝=0.66).Conclusion.Percutaneousfixation of spinopelvic dissociation is associated with significantly less blood loss. Treatment outcomes in terms of infection, lengthof stay, operative cost, and final alignment between the open and percutaneous group were similar