Outcome of Transpedicular Fixation in Thoracolumbar Fractures


  • Mahmood Khan Kibzai
  • Muhammad Haroon
  • Muhammad Shoaib Kibzai
  • Zeenat-un-Nisa




Objective:  The purpose of this study was to assess the clinical improvement in the post-op period in patients with thoracolumbar fractures who underwent transpedicular fixation.

Materials and Methods:  A retrospective study was conducted for 6 months in the Neurosurgery departments of private hospitals in Quetta. A total of 34 patients with trauma were included in the study who underwent Transpedicular screws and rods fixation (Including both long and short segment fixation). American Spinal Injury Association (ASIA) impairment scale was used to describe the individual’s functional impairment from spinal cord injury. Preoperative and postoperative comparison within 6 months.

Results:  There were 22 male and 12 female patients. The patients were between 18-45 years of age. There were 16 cases of the following vertebral fractures: D9, D10, D12, L1 in ASIA-A and ASIA-B grades. There were 6 cases of the following vertebral fractures: L1, L2 in ASIA-C grades. And 12 cases of L2, L3 vertebral fractures in ASIA-D and ASIA-E Grades. In ASIA Grade A, 25% of patients improved to ASIA C and 12.5% of patients improved to ASIA D postoperatively.  In ASIA Grade B, 25% of patients improved to ASIA C, and 25% of patients improved to ASIA-D post-operatively. In Asia-C Grade, 16.6% of patients improved to ASIA E, and 50% of patients improved to ASIA D postoperatively.

Conclusion:  In a considerable proportion of individuals, surgery resulted in superior clinical results. ASIA Grades A and B should also be operated early for greater clinical improvement.

Keywords:  Transpedicular Fixation, Thoracolumbar fractures, ASIA Scores.


Khan AA, Khanzada K, Ayub S, Ali M. Surgical outcome of transpedicular fixation in thoracolumbar fractures. J Ayub Med Coll Abbottabad, 2008; 20 (4): 104-7.

Jeffrey WP, Joel RL, Eldin EK, Robert WG. Successful Short-Segment Instrumentation and Fusion for Thoracolumbar Spine Fractures A Consecutive 4 1/2-Year Series. Spine, 2000; 25: 1157–69.

Singh R, Rohilla RK, Kamboj K, Magu NK, Kaur K. Outcome of pedicle screw fixation and monosegmental fusion in patients with fresh thoracolumbar fractures. Asian Spine Journal, 2014; 8 (3): 298.

Kothe R, Panjabi MM, Liu W. Multidirectional instability of the thoracic spine due to iatrogenic pedicle injuries during transpedicular fixation: a biomechanical investigation. Spine, 1997; 15; 22 (16): 1836-42.

Roy-Camille R, Saillant G, Salgado V. Osteogenesis of thoracolumbar spine fractures with metal plates screwed through the vertebral pedicle. Reconstr Surg Traumatol. 1976; 15: 2–16.

Dorr LD, Harvey JP, Nickel VL. Clinical review of the early stability of spine injuries. Spine, 1982; 7: 545–53.

Been HD, Bouma GJ. Comparison of two types of surgery for thoraco-lumbar burst fractures: combined anterior and posterior stabilisation vs. posterior instrumentation only. Acta Neurochirurgica. 1999; 141 (4): 349-57.

Bradford DS, Akbarnia BA, Winter RB, Seljeskog EL. Surgical stabilization of fracture and fracture dislocations of the thoracic spine. Spine, 1977; 2 (3): 185-96.

Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH, Vernon JD, Walsh JJ. The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Spinal Cord, 1969; 7 (3): 179-92.

Hashem S, Abdelbar A, Ibrahim H, Habib MA, Abdel-Monem A, Hamdy H. Review of Device and Operator Related Complications of Transpedicular Screw Fixation for the Thoracic and Lumbar Regions. Egyptian Journal of Neurology, Psychiatry & Neurosurgery, 2012; 49 (4).

American Spinal Injury Association. Worksheet International standards for neurological classification of spinal cord injury (ISNCSCI); Revised version November 2015. [Internet] Available from:


Accessed March 2022.

Han W, Zhong-li G, Jin-Cheng W, Ying-Pu L, Peng X, Rui J, Jun W. Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques. Orthopedics, 2010; 33 (8).

Li Q, Liu Y, Chu Z, Chen J, Chen M. Treatment of thoracolumbar fractures with transpedicular intervertebral bone graft and pedicle screws fixation in injured vertebrae. Zhongguo Xiufu Chong Jian waike za zhi= Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, 2011; 25 (8): 956-9.

Tang HZ, Xu H, Yao XD, Lin SQ. Single-stage

posterior vertebral column resection and internal fixation for old fracture–dislocations of thoracolumbar spine: a case series and systematic review. European Spine Journal, 2016; 25 (8): 2497-513.

Wang RY, Hua YJ, Chen JH, Chai JL, Shao LF, Zhao JF. Single-segment pedicle screw fixation for the treatment of thoracolumbar fractures through the gap of paravertebral muscles. Zhongguogu Shang = China Journal of Orthopaedics and Traumatology, 2012; 25 (1): 42-6.

Aly TA. Short segment versus long segment pedicle screws fixation in management of thoracolumbar burst fractures: meta-analysis. Asian Spine Journal, 2017; 11 (1): 150.

Upendra BN, Meena D, Chowdhury B, Ahmad A, Jayaswal A. Outcome-based classification for assessment of thoracic pedicular screw placement. Spine, 2008; 33 (4): 384-90.

Khare S, Sharma V. Surgical outcome of posterior short segment trans-pedicle screw fixation for thoracolumbar fractures. Journal of Orthopaedics, 2013; 10 (4): 162-7.

Yue JJ, Sossan A, Selgrath C, Deutsch LS, Wilkens K, Testaiuti M, Gabriel JP. The treatment of unstable thoracic spine fractures with transpedicular screw instrumentation: a 3-year consecutive series. Spine, 2002 15; 27 (24): 2782-7.

Kast E, Mohr K, Richter HP, Börm W. Complications of transpedicular screw fixation in the cervical spine. European Spine Journal, 2006; 15 (3): 327-34.

Lee SH, Sung JK, Park YM. Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. Clinical Spine Surgery, 2006; 19 (8): 595-602.

Peng J, Xu J. Research progress in surgical treatment of thoracolumbar fracture. Zhongguoxiu fu Chong Jian waike za zhi= Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, 2009; 23 (12): 1506-9.

Yang X, Huo H, Xiao Y, Xing W, Zhao Y, Fu Y. Pedicle screw fixation and allograft bone in posterior spinal fusion for treatment of thoracolumbar vertebral fractures. Zhongguoxiu fu Chong Jian waike za zhi= Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, 2009; 23 (5): 520-3.