Revista Cubana de Medicina Militar (Jun 2025)
Outcomes of treating unstable thoracolumbar fractures without spinal cord injury using percutaneous pedicle screw fixation
Abstract
Background: Unstable thoracolumbar fractures can lead to pain and limited mobility. Minimally invasive spinal surgery, particularly percutaneous pedicle screw fixation, has shown promise in restoring spinal stability with reduced soft tissue damage and faster recovery. Objectives: To evaluate the outcomes of treating thoracolumbar fractures via percutaneous pedicle screw fixation. Methods: A retrospective case series was conducted on 32 patients with unstable thoracolumbar fractures (T11–L2) without spinal cord injury. Exclusion criteria included neurological deficits, pathological fractures, or incomplete records. Operative time, blood loss, complications, VAS scores, Cobb angles, and Macnab criteria were assessed. Surgery was performed under fluoroscopic guidance via small incisions without muscle detachment. Results: Among the 32 patients, 20 were males (62.5%) and 12 were females (37.5%), with a mean age of 46.2 ± 11.1 years. The average preoperative kyphotic angle was 14.4°±4.3°, which decreased to 8.1°±3.6° postoperatively (t value= 15.153; p<0.001). The mean pain score, measured by the visual analog scale (VAS), was 6.8±1.5 preoperatively and decreased to 1.2±0.7 at six months postoperatively (p<0.05). Intraoperative complications included one case of lateral pedicle wall injury. Postoperative complications included one case of superficial infection at the surgical site. The Macnab criteria were rated as excellent in 31 patients (96.9%) and good in 1 patient (3.1%). Conclusions: Percutaneous pedicle screw fixation is a safe and effective method for treating unstable thoracolumbar fractures without spinal cord neurological impairment.
