Analysis of the short-term effect of three different level pedicle screws in the treatment of thoracolumbar type A fractures.

Abstract

Objective: The effects of three short-segment vertebral fixation methods-short-segment fixation (4s group), short-segment fixation across the injured vertebra (6s group), and long-segment fixation (8s group)-on the surgical efficacy of patients with type A thoracolumbar fractures were compared to identify the optimal fixation method.

Methods: Data from 277 patients who underwent posterior pedicle screw fixation for thoracolumbar fractures between September 2018 and January 2023 were retrospectively analyzed. Surgery-related indicators, laboratory parameters, clinical functional measures (VAS and ODI), and postoperative imaging findings were compared among the three groups.

Results: Baseline data showed no significant differences among the three groups. The operation time in the 4s group (75.352 ± 15.458 min) and intraoperative blood loss (188.65 ± 42.728 ml) were significantly lower compared to the 8s group (operation time: 108.243 ± 19.529 min; intraoperative blood loss: 209.93 ± 50.542 ml), with statistically significant differences (p < 0.05). Postoperative hematocrit (33.277 ± 4.639) and albumin levels (34.971 ± 4.116) in the 6s group were significantly higher than those in the 8s group (hematocrit: 31.820 ± 4.323; albumin: 33.170 ± 3.553), with p < 0.05. Other outcome indicators did not show statistically significant differences (p > 0.05).

Conclusion: Short-segment fixation across the injured vertebra (6s) provides results comparable to short-segment fixation (4s) while causing less trauma. Furthermore, the 6s method demonstrates similar efficacy to long-segment fixation (8s) in maintaining long-term deformity correction. These findings offer valuable insights for clinicians in selecting surgical fixation methods, optimizing treatment strategies, and improving patient outcomes.