Examining the Postoperative Outcomes After Minimally Invasive Versus Open Fixation of Thoracolumbar Fractures in Patients With Ankylosing Spondylitis: A Systematic Review and Meta-analysis.

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13 studies including 443 patients with ankylosing spondylitis (AS) and thoracolumbar (TL) fractures were included in this systematic review and meta-analysis comparing minimally invasive surgery (MIS) using percutaneous pedicle screw fixation with conventional open fixation. Pooled outcomes included bony healing, operative time, intraoperative blood loss, hospital length of stay, and revision surgery. Patient-reported pain and disability outcomes were also evaluated. MIS was associated with significantly shorter operative time, reduced blood loss, and shorter hospital stays compared with open fixation, while bony healing and revision surgery rates were comparable between approaches. Both techniques improved postoperative pain and function. These findings suggested that MIS offered perioperative advantages without compromising fracture healing, making it a promising alternative to open fixation in appropriately selected patients with AS.