Evaluation of Clinical, Functional, and Radiological Outcomes in Patients with Thoracolumbar Spine Fractures Treated with Posterior Pedicle Screw Fixation

Abstract

Background: Thoracolumbar spine fractures are common consequences of high-energy trauma and may result in spinal instability, neurological impairment, deformity, and long-term functional disability. Posterior pedicle screw fixation is widely used to restore spinal stability, correct kyphotic deformity, and facilitate early mobilization. Objectives: To evaluate clinical, functional, and radiological outcomes in patients with thoracolumbar spine fractures treated with posterior pedicle screw fixation. Materials and Methods: A prospective observational study was designed involving 120 patients with thoracolumbar fractures treated using posterior pedicle screw fixation. Clinical outcomes were assessed using the Visual Analogue Scale (VAS), neurological status using the American Spinal Injury Association (ASIA) Impairment Scale, and functional outcomes using the Oswestry Disability Index (ODI). Radiological assessment included regional kyphotic angle and anterior vertebral body height. Outcomes were evaluated preoperatively and during postoperative follow-up. Results: In the observed dataset, mean VAS pain score decreased from 7.8 ± 1.1 preoperatively to 1.9 ± 0.9 at 12 months, while mean ODI improved from 64.2 ± 10.6 to 18.4 ± 7.8. Mean kyphotic angle decreased from 21.6° ± 6.4° preoperatively to 8.2° ± 3.5° immediately postoperatively and was 10.1° ± 4.2° at 12 months. Anterior vertebral body height improved from 58.4% ± 11.2% to 85.6% ± 8.4% postoperatively. Neurological improvement was recorded in patients with incomplete deficits, while implant-related complications were uncommon. Conclusion: Posterior pedicle screw fixation provides a useful surgical approach for selected unstable thoracolumbar fractures, with potential improvements in pain, functional disability, spinal alignment, and vertebral body height. Appropriate patient selection, anatomical reduction, stable instrumentation, and structured rehabilitation remain important determinants of postoperative recovery.

Keywords: Thoracolumbar fracture; Posterior pedicle screw fixation; Kyphotic angle; Oswestry Disability Index; Visual Analogue Scale; Neurological recovery; Radiological outcomes.