ArticleWorld journal of orthopedics2025
Factors that influence long term instrumentation stability in patients with unstable thoracolumbar injuries.
Article in World journal of orthopedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- 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
- Enhancing long-term fixation in thoracolumbar injuries: From screw design to bone quality optimization.World journal of orthopedics · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPedicle screw fixation is frequently used to treat unstable thoracolumbar injuries; however, the rate of instrumentation failure remains considerable. The primary contributing factor leading to instrumentation failure is poor bone quality. On the other hand, some evidence suggests that surgical tactics can influence long-term instrumentation stability.
aimTo assess factors that influence the stability of spinal instrumentation in patients with thoracolumbar injuries.
methodsThis study is a non-randomized single center ambispective evaluation of 204 consecutive patients (117 men; 87 women) with unstable thoracolumbar injuries. All patients underwent either stand-alone or combined with anterior column reconstruction instrumentation. In cases with spinal cord and nerve root injuries, either posterior or anterior decompression were performed. Patients with pedicle screw loosening were identified
resultsThe rate of pedicle screw loosening detected by computed tomography was inversely correlated with bone radiodensity figures and an increased association with the number of instrumented levels, residual kyphotic deformity, laminectomy, and lumbosacral fixation. Intermediate screws and anterior reconstruction were associated with a clinically relevant decreased risk of pedicle screw loosening development. Either complete or partial posterior fusion within instrumented levels was capable of decreasing instrumentation failure risk, while extensive decompression with laminectomy and at least one-level total facetectomy were associated with an increased risk of instrumentation failure. Anterior decompression does not have a negative impact on instrumentation stability.
conclusionIntermediate screws, anterior reconstruction and posterior tension band preservation are associated with decreased rates of instrumentation instability development. Posterior fusion is beneficial in terms of instrumentation failure prevention.
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