Biomechanical Outcome of Short Segment Trans-pedicular Fixation at Thoraco-Lumbar Junction Fractures with Incorporation of Screws at Fractured Level

Abstract

Objective:  Despite consensus on the surgical management of thoracolumbar fractures, considerable controversy exists regarding the correction of kyphotic deformity. This study is to evaluate the extent of correction of kyphotic deformity in 6S short-segment TP Fixation (6S-SSF) with incorporation of Screws into fractured vertebrae in Thoracolumbar Junction Fractures (TLJ).

Material and Methods:  This retrospective cohort study analyzed 34 patients with unstable thoracolumbar fractures (T10-L3) treated with six-screw short-segment transpedicular fixation between March 2019 and February 2021. Primary outcomes included correction of kyphotic deformity and maintenance of reduction at 12-month follow-up. Secondary outcomes encompassed vertebral height restoration and functional scores.

Results:  The cohort comprised 25 males (73.5%) and 9 females (26.5%) with a mean age of 37.2 ± 9.8 years. L1 fractures predominated (41.2%), followed by T12 fractures (29.4%). Mean preoperative kyphotic angle measured 16.3° ± 4.2°, improving to 7.6° ± 3.1° postoperatively. At 12-month follow-up, the kyphotic angle measured 8.1° ± 3.4°, representing minimal correction loss of 0.5° ± 1.2°.

Conclusion:  The Six-screw short-segment transpedicular fixation in thoracolumbar fractures, including the fractured vertebra, demonstrates superior biomechanical stability with effective kyphotic correction and minimal loss of reduction as compared to traditional four-screw constructs.