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Short-Segment Posterior Fixation with Intermediate Screws for Unstable Thoracolumbar Fractures
Ali A Al-Omari1, Yazan Anaqreh1, Mutaz Abueed1
1Division of Orthopedic Surgery, Department of Special Surgery, Faculty of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan.
World Neurosurgery
|May 29, 2026
Summary
Posterior fixation including the fractured vertebra (PFFV) effectively treats severe unstable thoracolumbar fractures, improving spinal alignment and patient function. This surgical technique demonstrates good outcomes with low complication rates.
Area of Science:
- Orthopedic Surgery
- Spinal Surgery
- Traumatology
Background:
- Unstable thoracolumbar fractures present complex treatment challenges.
- The optimal surgical strategy for these injuries is debated.
- Posterior fixation including the fractured vertebra (PFFV) is a proposed technique balancing stability and motion preservation.
Purpose of the Study:
- To evaluate the safety and efficacy of PFFV for severe unstable thoracolumbar fractures.
- To assess radiological and functional outcomes following PFFV.
- To determine the long-term results of PFFV in this patient cohort.
Main Methods:
- Retrospective review of 161 patients with severe unstable thoracolumbar fractures treated with PFFV (2014-2021).
- Assessment of demographic, operative, radiological (Cobb angle, body compression), and functional (ASIA, ODI, VAS) outcomes.
- Minimum 24-month follow-up to evaluate long-term results.
Main Results:
- Successful PFFV with no implant failures and a low complication rate (4% wound infections).
- Significant improvements in radiological parameters (Cobb angle, body compression) maintained at follow-up.
- Favorable functional outcomes with neurological improvement in most patients and good patient-reported scores (ODI 16%, VAS 2).
Conclusions:
- PFFV is a safe and effective surgical option for severe unstable thoracolumbar fractures.
- The technique leads to significant improvements in spinal alignment and functional outcomes.
- Further prospective studies are needed to compare PFFV directly with alternative surgical methods.
