Efficacy of Pedicle Screw Fixation in Unstable Upper and Middle Thoracic Spine Fractures

Background: Treatment of unstable upper and middle thoracic spine fractures remains controversial. There is no consensus regarding optimal treatment. Objectives: In this study, we evaluated the efficacy of pedicular screw in the management of middle thoracic spine fractures to correct kyphosis and anterolisthesis and improve neurologic condition of patients. Patients and Methods: Twenty-five patients with unstable T1-T10 fractures treated with pedicle screw fixation technique were studied. Neurologic situation, preoperative and postoperative radiographs were evaluated. Radiographic measurements included kyphotic deformity and anterolisthesis. An American Spinal Injury Association (ASIA) scale was used for neurologic classification of the patients. Results: From a total of 25 patients, 21 cases were male and 4 were female. The mean age of the patients was 35.40 +/- 14.39 years. The mean degree of kyphosis improved from 27.04 +/- 7.33 degrees preoperatively to 15.96 +/- 5.76 degrees at final follow-up. The mean of anterolisthesis improved from 6.44 +/- 4.93 mm to 0.96 +/- 0.36 mm at final follow-up. Kyphosis (P = 0.0001), anterolisthesis (P = 0.0001) and neurological state (P = 0.01) improved significantly after operation. No cases of hardware failure, neurological deterioration and loss of correction were reported. Conclusions: Application of pedicular screw in unstable upper and middle thoracic spine fractures is an effective method that can correct kyphotic deformity and anterolisthesis and improve neurologic deficit.