Comparison of Minimally Invasive Versus Open Spinopelvic Fixation for Unstable Sacral Fractures

Completed

• Conditions: Sacral Fracture

• Registration Number: NCT06755580
• Lead Sponsor: F.D. Roosevelt Teaching Hospital with Policlinic Banska Bystrica

Brief Summary

The aim of this retrospective study is to evaluate patients with vertically unstable high-energy sacral fracture operated on at our institution with spinopelvic fixation, to compare the traditionally open method of fixation with the minimally invasive fixation. The aim of the research is to determine whether minimally invasive surgical techniques can achieve comparable fracture reduction and functional outcome as open surgical approaches. Another aim is to determine whether the minimally invasive surgical procedure leads to shorter patient hospitalization, lower perioperative blood loss, and lower postoperative complications.

Detailed Description

This retrospective study included 51 patients with vertically unstable sacral fracture operated at our institution with open or minimally invasive spinopelvic fixation over a period of 11 years (2014-2024). The patients were divided into two groups. One group of patients underwent open spinopelvic fixation, the other group underwent minimally invasive spinopelvic fixation. Each patient underwent a CT scan before and after surgery. The degree of fracture dislocation and reduction was measured in three planes at each examination. The degree of reduction was divided into four groups according to residual dislocation. In the perioperative period, blood loss, the length of the surgical procedure from the first incision to the suture of the wounds, and radiation exposure were monitored. Intraoperative blood loss was calculated from the waste in the surgical suction system. Functional outcome was assessed one year after surgery. A standardized questionnaire according to the Majeed score was used to assess functional outcome.

Study Timeline

• Study Start: 2014-01-01
• Primary Completion: 2024-12-16
• Study Completion: 2024-12-18
• Study First Submitted: 2024-12-20
• Study First Submitted QC: 2024-12-31
• Study First Posted: 2025-01-01
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-21
• Last Update Posted: 2025-02-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 51

Inclusion Criteria

• patient with high energy vertically unstable sacral fracture
• patients operated with open or minimally invasive spinopelvic fixation
• patients followed up for at least one year

Exclusion Criteria

• patients with low-energy osteoporotic fractures of the sacrum
• patients with insufficiency fractures of the sacrum
• patients operated on using a method other than spinopelvic fixation
• patients who were not followed up for at least one year after surgery

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
pelvic ring symmetry	up to 1 year	position of fracture fragments before and after surgery measured in three planes on CT scan
invasiveness of the surgical procedure	in perioperative period	The invasiveness of the surgical procedure was measured based on perioperative blood loss. Perioperative blood loss was calculated from the waste in the surgical suction system (mililiters)
length of the surgical procedure	in perioperative period	length of the surgical procedure from the first incision to the suture of the wounds
radiation exposure of the patient during surgical procedure	in perioperative period	radiation exposure of a patient during a surgical procedure measured by the X-ray machine used during the operation (microgray/m2)
Functional outcome after surgery based on a standardized questionnaire according to the Majeed score	one year after surgery	One year after surgery, patients fill out a standardized questionnaire according to the Majeed scoring system. Majeed score is a pelvic injury-specific functional assessment that comprises seven items, including pain, work, sitting, sexual intercourse, standing, unaided gait, and walking distance, with a total score range of 0 (worst outcome) to100 (best outcome), in order of decreasing disability.
complications	1 year	During the observation period, postoperative complications such as wound infection, loosening of osteosynthetic material, loss of reduction, nonunion, and newly developed neurological deficit will be recorded in patients.

Trial Locations

Locations (1)

F.D. Roosevelt Teaching Hospital with Policlinic Banska Bystrica; 🇸🇰 Banska Bystrica, Slovakia