Analysis of factors associated with the failure of treatment in thoracolumbar burst fractures treated with short-segment posterior spinal fixation.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that they have no competing interests. 10. Indian J Orthop. 2025 Jun 12;59(8):1265-1273. doi: 10.1007/s43465-025-01433-2. eCollection 2025 Aug. Single vs Double Index Screws in Thoracolumbar Burst Fractures: A Retrospective Analysis. Thangamani V(1), Kumar G(1), Raj ND(1), Jeyashankaran BR(1), Raju S(1), Muthu C(1). Author information: (1)Department of Spine Surgery, Preethi Institute of Medical Sciences and Research, Melur Main Road, Uthangudi, Madurai, Tamil Nadu 625107 India. STUDY DESIGN: Retrospective study. OBJECTIVES: To assess the radiological, clinical, and neurological outcome of patients who had thoracolumbar burst fractures and had undergone short-segment posterior stabilization with single-index screw (SIS) or double-index screws (DIS) at the fractured vertebra. METHODS: We included patients with AO type A and B with thoracolumbar injury classification and severity score (TLICS) ≥ 5, load-sharing classification (LSC) score ≥ 7, and a follow-up period of more than 2 years. Of 94 patients, 45 had DIS fixation, and 49 had SIS fixation. All patients' pre-operative, immediate post-operative, and final follow-up visit X-rays were analyzed for Cobb's angle (CA), vertebral wedge angle (VWA), and vertebral body compression ratio (VBCR) in a neutral lateral view and transverse spinal area (TSA) in axial CT section. Clinical and neurological outcomes were assessed using the Visual Analog Scale (VAS) for back pain, the Oswestry Disability Index (ODI), and the American Spinal Injury Association (ASIA) Impairment Scale (AIS) at their final follow-up visit. RESULTS: The radiological parameters between both groups showed significant differences in terms of CA, VWA, and VBCR at the latest follow-up (SIS: 12.5°, 15°, 80.1% vs DIS: 8.04°, 11.2°, 87.1%) (p  0.05). CONCLUSIONS: Short-segment posterior stabilization with DIS in the fractured vertebra resulted in radiologically better maintenance of CA, VWA, and VBCR compared to SIS. There were no significant differences in terms of clinical (VAS and ODI), neurological outcome (AIS), and spinal canal remodeling (TSA). © Indian Orthopaedics Association 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. DOI: 10.1007/s43465-025-01433-2 PMCID: PMC12367613