Efcacy of Pedicle Screw Fixation in Unstable Upper and Middle Thoracic Spine Fractures

Treatment of unstable upper and middle thoracic spine fractures remains controversial. There is no consensus regarding
optimal treatment.
Objectives: In this study, we evaluated the efcacy of pedicular screw in the management of middle thoracic spine fractures to correct
kyphosis and anterolisthesis and improve neurologic condition of patients.
Patients and Methods: Twenty-fve patients with unstable T1-T10 fractures treated with pedicle screw fxation technique were studied.
Neurologic situation, preoperative and postoperative radiographs were evaluated. Radiographic measurements included kyphotic
deformity and anterolisthesis. An American Spinal Injury Association (ASIA) scale was used for neurologic classifcation of the patients.
Results: From a total of 25 patients, 21 cases were male and 4 were female. The mean age of the patients was 35.40 ± 14.39 years. The mean
degree of kyphosis improved from 27.04 ± 7.33 degrees preoperatively to 15.96 ± 5.76 degrees at fnal follow-up. The mean of anterolisthesis
improved from 6.44 ± 4.93 mm to 0.96 ± 0.36 mm at fnal follow-up. Kyphosis (P = 0.0001), anterolisthesis (P = 0.0001) and neurological
state (P = 0.01) improved signifcantly after operation. No cases of hardware failure, neurological deterioration and loss of correction were
reported.
Conclusions: Application of pedicular screw in unstable upper and middle thoracic spine fractures is an effective method that can correct
kyphotic deformity and anterolisthesis and improve neurologic defcit