Background
To evaluate the use of an additional pedicle screw for unstable thoracolumbar spine injuries.
Patients and methods
Thirty patients with unstable thoracolumbar spine injuries were included in the study. All patients underwent open reduction and internal fixation using a posterior approach. Pedicles were localized using anatomical landmarks and intraoperative imaging. Patients were followed up for 1 year.
Results
There were 30 patients with unstable thoracolumbar junction injuries who were managed with pedicle screws and rods with the addition of intermediate screws. Men were more affected (the male : female ratio was about 2 : 1). Wedge compression and burst were the most common. About 28 patients were neurologically free, one with Frankel B, and another one with Frankel C. The two patients with neurological impairment showed improved neurology by at least one Frankel grading. No postoperative neurological deterioration was observed; metal failure occurred in two patients after 1 year of follow-up.
Conclusion
Pedicle screw fixation is a good choice for thoracolumbar junction injuries to achieve reduction and stability; additional fixation (intermediate screw at the fractured level) provides significant correction of vertebral body height and local kyphosis, and maintains the correction.