This retrospective observational study evaluates the clinical and radiological outcomes of pedicle screw fixation using the postero-lateral intermuscular minimally invasive open approach (PLOA) in patients with thoraco-lumbar spinal pathologies requiring stabilization without extensive decompression. Conventional posterior midline open approach is associated with significant muscle dissection, blood loss, post-operative pain, and delayed recovery. PLOA follows a muscle-sparing anatomical plane, aiming to reduce tissue damage while allowing accurate pedicle screw placement.

A total of 47 non-consecutive patients operated between January 2016 and January 2022 were included, with a minimum follow-up of 24 months. Pre-operative demographic and clinical parameters, intra-operative variables (blood loss, operative time, screw accuracy), and post-operative outcomes (analgesic requirement, hospital stay, radiological correction, complications, and implant status) were analyzed. Standard classification systems were used based on pathology (trauma, tumor, infection). The study aims to assess the safety, effectiveness, and indications of PLOA as a cost-effective alternative to conventional and percutaneous techniques, especially in resource-limited settings.