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Objective <p>In this retrospective study, we aimed to evaluate the feasibility, safety, and effectiveness of percutaneous posterior pedicle screw fixation (PPSF) using the FFM(fixed-axis pedicle screws at the injured vertebra and the vertebra above, and multiaxial pedicle screws at the vertebra below) fixation configuration for traumatic thoracolumbar fractures (TLFs) in comparison with conventional percutaneous PPSF and FFM via the Wiltse approach.</p> Methods <p>A total of 102 patients with traumatic TLF who were treated between January 2020 and October 2023 were included and divided into three groups: FFM group (percutaneous PPSF using the FFM fixation configuration), FMF group (conventional percutaneous PPSF with multiaxial screws at the fractured vertebra), and Wiltse group (FFM via Wiltse approach). Radiological and clinical outcomes were assessed at pre-operative, postoperative, and follow-up intervals. Perioperative indicators, such as operative time, blood loss, and incision length, were also recorded.</p> Results <p>Demographic characteristics were similar among the three groups. At 1&#xa0;week postoperatively, the FFM group achieved significantly better radiological outcomes than the FMF group, with similar values to the FFM via Wiltse group: VWA (FFM: 6.01 ± 1.96°, FMF: 9.39 ± 2.06°, Wiltse: 6.29 ± 1.27°), AVBH (FFM: 91.26 ± 3.10%, FMF: 85.35 ± 6.40%, Wiltse: 90.54 ± 5.58%), VBI (FFM: 93.45 ± 4.89%, FMF: 88.27 ± 6.64%, Wiltse: 92.96 ± 3.58%) (<i>P</i> &lt; 0.01 for FFM vs FMF; <i>P</i> &gt; 0.05 for FFM vs Wiltse). At the latest follow-up, correction loss of VWA, AVBH, and VBI was significantly lower in the FFM group (1.83 ± 0.62°, 4.70 ± 1.00%, 4.88 ± 3.74%) and FFM via Wiltse group (1.99 ± 0.65°, 4.83 ± 1.19%, 5.28 ± 3.15%) groups than in the FMF group (2.55 ± 0.88°, 6.01 ± 0.81%, 6.57 ± 2.98%) (<i>P</i> &lt; 0.05), with no significant differences between FFM and Wiltse groups (<i>P</i> &gt; 0.05).At 1&#xa0;week, the FFM and FMF groups reported significantly lower VAS and ODI scores than the Wiltse group (VAS: 2.1 ± 0.8 and 2.0 ± 0.7 vs. 2.7 ± 0.7; ODI: 35.3 ± 11.1 and 38.1 ± 10.0 vs. 44.3 ± 10.7; <i>P</i> &lt; 0.05). No functional differences were noted among groups at later follow-up. The FFM and FMF groups had shorter incisions, operative time, reduced blood loss, and shorter hospital stays compared to the Wiltse group (<i>P</i> &lt; 0.01).</p> Conclusion <p>Compared to the FMF configuration, it provides superior radiological outcomes (VWA, AVBH, VBI); the FFM group also reduces blood loss and trauma, compared to the FFM via Wiltse approach group. The FFM configuration for percutaneous PPSF is an effective, minimally invasive technique for managing traumatic TLFs.</p> Trial registration <p>Ethics Committee of the General Hospital of the Central Theater Command [2025]066–01, Retrospectively registered. Date of registration: February 24, 2025.</p>

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Clinical efficacy and radiological outcomes of a novel screw placement technique for the treatment of traumatic thoracolumbar vertebral fractures under navigation guidance

  • 期刊论文

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  • 发表日期：

    2025年10月1日

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  • Biwang Huang,
  • Kangheng Niu,
  • Le Cheng,
  • Zhong Wei,
  • Xuepeng Wang,
  • Zhenzhen Tao,
  • Tanjun Wei,
  • Feng Xu,
  • Chengjie Xiong

摘要

Objective

In this retrospective study, we aimed to evaluate the feasibility, safety, and effectiveness of percutaneous posterior pedicle screw fixation (PPSF) using the FFM(fixed-axis pedicle screws at the injured vertebra and the vertebra above, and multiaxial pedicle screws at the vertebra below) fixation configuration for traumatic thoracolumbar fractures (TLFs) in comparison with conventional percutaneous PPSF and FFM via the Wiltse approach.

Methods

A total of 102 patients with traumatic TLF who were treated between January 2020 and October 2023 were included and divided into three groups: FFM group (percutaneous PPSF using the FFM fixation configuration), FMF group (conventional percutaneous PPSF with multiaxial screws at the fractured vertebra), and Wiltse group (FFM via Wiltse approach). Radiological and clinical outcomes were assessed at pre-operative, postoperative, and follow-up intervals. Perioperative indicators, such as operative time, blood loss, and incision length, were also recorded.

Results

Demographic characteristics were similar among the three groups. At 1 week postoperatively, the FFM group achieved significantly better radiological outcomes than the FMF group, with similar values to the FFM via Wiltse group: VWA (FFM: 6.01 ± 1.96°, FMF: 9.39 ± 2.06°, Wiltse: 6.29 ± 1.27°), AVBH (FFM: 91.26 ± 3.10%, FMF: 85.35 ± 6.40%, Wiltse: 90.54 ± 5.58%), VBI (FFM: 93.45 ± 4.89%, FMF: 88.27 ± 6.64%, Wiltse: 92.96 ± 3.58%) (P < 0.01 for FFM vs FMF; P > 0.05 for FFM vs Wiltse). At the latest follow-up, correction loss of VWA, AVBH, and VBI was significantly lower in the FFM group (1.83 ± 0.62°, 4.70 ± 1.00%, 4.88 ± 3.74%) and FFM via Wiltse group (1.99 ± 0.65°, 4.83 ± 1.19%, 5.28 ± 3.15%) groups than in the FMF group (2.55 ± 0.88°, 6.01 ± 0.81%, 6.57 ± 2.98%) (P < 0.05), with no significant differences between FFM and Wiltse groups (P > 0.05).At 1 week, the FFM and FMF groups reported significantly lower VAS and ODI scores than the Wiltse group (VAS: 2.1 ± 0.8 and 2.0 ± 0.7 vs. 2.7 ± 0.7; ODI: 35.3 ± 11.1 and 38.1 ± 10.0 vs. 44.3 ± 10.7; P < 0.05). No functional differences were noted among groups at later follow-up. The FFM and FMF groups had shorter incisions, operative time, reduced blood loss, and shorter hospital stays compared to the Wiltse group (P < 0.01).

Conclusion

Compared to the FMF configuration, it provides superior radiological outcomes (VWA, AVBH, VBI); the FFM group also reduces blood loss and trauma, compared to the FFM via Wiltse approach group. The FFM configuration for percutaneous PPSF is an effective, minimally invasive technique for managing traumatic TLFs.

Trial registration

Ethics Committee of the General Hospital of the Central Theater Command [2025]066–01, Retrospectively registered. Date of registration: February 24, 2025.