SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
Pedicle screw fixation of thoracolumbar fractures: conventional short segment versus short segment with intermediate screws at the fracture level-a systematic review and meta-analysis.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06561997 (Enhancing Thoracolumbar Burst Fracture Treatment), which is not on this map. Cited by 58 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Enhancing Thoracolumbar Burst Fracture Treatment: The Advantage of Robot-Assisted Posterior Fixation for Improved Reduction and Collapse Prevention
Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Morphometric measurement of lumbar pedicle in different regions: a systematic review.Journal of orthopaedic surgery and research · 2023Pooled it
- Whether patients with load sharing classification (LSC) score ≤ 6 need the additional screws in the fractured vertebra?: a prospective randomized study with 2 years of follow up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Trial
- Factors associated with radiographic and clinical outcomes after posterior long-segment instrumentation for neurologically intact thoracolumbar fractures: a single-center retrospective study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Anatomical and biological reconstruction of traumatic complete burst fractures of the thoracolumbar vertebrae using pedicle fixation combined with stent-armed kyphoplasty and intracorporeal bone grafting: technique rationale, 7-year experience and clinical, imaging, and histological outcomes.Journal of spine surgery (Hong Kong) · 2026Article
- Does surgical approach or preoperative deformity better predict outcomes in thoracolumbar fractures? A comparative study of minimally invasive versus open techniques.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Intermediate screw placement improves initial radiographic alignment but not clinical outcomes following long-segment fixation for thoracolumbar fractures.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Biomechanical comparison of posterior short-segment fixation with or without intermediate screws for thoracolumbar burst fractures under normal and osteoporotic conditions: a finite element analysis.Asian spine journal · 2026Article
- The role of intracorporeal cancellous bone grafting in the biological augmentation of vertebral body fractures: a literature review, historical perspective, and update on imaging and bone healing outcomes.Journal of spine surgery (Hong Kong) · 2026Review
- Does Size Matter? Evaluating the Impact of Intermediate Screw Length in Short-Segment Fixation of Thoracolumbar A3-A4 Fractures.Journal of clinical medicine · 2026Article
- Evaluation of Outcomes from Pedicle Screw Fixation Before and After Laminectomy : Short title: Outcomes of Pedicle Screw Fixation Before and After Laminectomy.Galen medical journal · 2026Article
- Enhancing long-term fixation in thoracolumbar injuries: From screw design to bone quality optimization.World journal of orthopedics · 2025Article
- Robot-Assisted, Conventional Fluoroscopy (C-Arm), O-Arm Navigation, and Freehand Pedicle Screw Fixation in Thoracolumbar Spine Fracture Surgery: A Network Meta-Analysis.Orthopaedic surgery · 2025Review
- [Clinical study of percutaneous short-segment injured vertebra pedicle screw fixation combined with bone grafting in treatment of thoracolumbar fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Clinical and Radiological Efficacy of Short-SegmentKorean journal of neurotrauma · 2025Article
- Clinical efficacy and radiological outcomes of a novel screw placement technique for the treatment of traumatic thoracolumbar vertebral fractures under navigation guidance.BMC musculoskeletal disorders · 2025Article
- Does the length of the intermediate pedicle screw influence outcome in unstable thoracolumbar burst fractures? A prospective randomized study in India.Asian spine journal · 2025Article
- A comparative analysis of three distinct approaches for the management of type A1 traumatic thoracolumbar fractures: a retrospective cohort study with a minimum 6-year follow-up.Journal of orthopaedic surgery and research · 2025Article
- Factors that influence long term instrumentation stability in patients with unstable thoracolumbar injuries.World journal of orthopedics · 2025Article
- Do More Screws Mean Better Stability? Four (4S) vs. Six (6S) Screws for Short-Segment Fixation in Thoracolumbar Fractures-A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Single vs Double Index Screws in Thoracolumbar Burst Fractures: A Retrospective Analysis.Indian journal of orthopaedics · 2025Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePosterior short-segment fixation (4-screw construct = 4S) is the conventional surgical technique for thoracolumbar fractures. The effect of adding two intermediate pedicle screws at the fractured level (6-screw construct = 6S) is still a matter of debate. This review aims to compare the results between 4 and 6S pedicle screw fixation for thoracolumbar fractures.
methodsA systematic review and meta-analysis were performed. The databases PubMed, Embase and Google Scholar were searched until January 2020. Inclusion criteria were studies comparing 4S and 6S techniques in patients with thoracolumbar fractures. Non-comparative studies and studies without full text were excluded. Cochrane risk of bias was assessed, and the GRADE approach was used to present the quality of evidence.
resultsTwenty-seven studies, of which 21 randomized controlled trials, with a total of 1890 patients (940 with 4S and 950 with 6S) were included. Meta-analysis showed that the 6S technique resulted in significantly lower pain scores, better short-term and long-term Cobb angles, less loss of correction and less implant failures. However, longer operation time and more blood loss were seen with the 6S technique. Length of hospital stay, Oswestry Disability Index scores and infections did not differ significantly between the 6S and 4S techniques. Quality of the evidence according to GRADE was moderate to low.
conclusionIn the treatment of thoracolumbar fractures, adding intermediate screws at the fracture level (6S) results in less post-operative pain, better radiological outcomes and less implant failure at the cost of a longer operation time and higher blood loss.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.