The use of intermediate pedicle screw fixation in burst fractures of the thoracolumbar transition

The implantation of the short-segment pedicle screw fi tion hardware (PSFH) is a standard surgery for the management of thoracolumbar spine injuries. The disadvantage of this technique is the frequent implant failure along with the deformity and back pain recurrence. The intermediate PSFHsupplemented with another two screws inserted into the fractured vertebrae has been described in the studies; however no outcomes of PSFH supplemented with just one intermediate screw and thus ensuring further anterior fusion without rearranging the system have even been presented. Methods. We analyzed the surgical outcomes of 109 (71 men, 38 women) 36 (29; 43.5) years old patients with Th L1, L2 type A3 (78) or A4 (31) AOSpine fractures using retrospective, single-center, non-randomized methods. The patients were divided into two groups: Group I - 58 patients with the standard 4 screws short-segment fi tion hardware; Group II - 51 patients who had their PSFH supplemented with another pedicle screw inserted into the fractured vertebrae. The outcomes were assessed by the severity pattern of pain and kyphotic deformity, the anterior column height, the implant failure and the loss of correction. The computer tomography findings were used to design solid finite element models of the spines and PSFH layout options including biomechanic bone-hardware simulation. Th s involved the simulation of the loading for the operated area that corresponded to normal physiology. Results. The patients were comparable in their age and height, their division was determined by the level and type of their fractures, the anterior column height of the fractured vertebra, and the severity of back pain. The post-surgery follow-up revealed signifi ant (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }