ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1605583
This article is part of the Research TopicFrom Crosstalk Among Cell Populations in the Microenvironment of Bone Degenerative Diseases to the Novel Therapeutic ApproachesView all 7 articles
The retrospective analysis of clinical and radiological results of treatment of thoracolumbar vertebral fractures with monoplanar pedicle screws instrument compared with fixed-axis and polyaxial screws
Provisionally accepted
- 1Department of Orthopaedics, Xijing hospital, Fourth Military Medical University, Xi'an, China
- 2Department of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shanxi Province, China
- 3Xi'an Medical University, Xi'an, China
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Background: Pedicle screw fixation is widely utilized in thoracolumbar fractures to restore vertebral height and spinal alignment. Screw head design varies among fixed-axis (rigid), polyaxial (multiplanar mobility), and monoplanar (coronal mobility) types, impacting surgical outcomes. This study compares clinical and radiological outcomes of these screws.Methods: Seventy-five patients (2020–2024) with thoracolumbar fractures were divided into three groups: Group A (fixed-axis screws, n=31), Group B (polyaxial screws, n=19), and Group C (monoplanar screws, n=25). Operative time, blood loss, radiographic parameters (anterior body compression index, vertebral body angle, regional Cobb angle), and Visual Analogue Scale (VAS) scores were assessed preoperatively, postoperatively, and at 3 and 12 months.Results: Group C (monoplanar) demonstrated significantly lower blood loss (64±11.1 mL vs. 308.6±88.8 mL, p<0.05) and shorter operative time (88±8.2 min vs. 158.9±27.8 min, p<0.05) than Group A, with no significant differences compared to Group B. Postoperative VAS improved across all groups (p<0.05), though Group A had slightly higher scores. Radiographic correction loss occurred in all groups at 12 months (p<0.05), but was more pronounced in Group B. No complications (infection, nerve injury) were observed.Conclusions: Monoplanar pedicle screws, combining coronal mobility for minimally invasive placement and sagittal rigidity for stability, reduce blood loss and operative time compared to fixed-axis screws while maintaining comparable correction retention to polyaxial screws. These findings position monoplanar screws as a balanced option for thoracolumbar fracture fixation, optimizing minimally invasive benefits without compromising mechanical strength.
Keywords: Thoracolumbar fracture, Monoplanar pedicle screws, Minimally invasive, Radiological outcomes, Biomechanical stability
Received: 03 Apr 2025; Accepted: 03 Jul 2025.
Copyright: © 2025 Duan, Zhao, Chang, Sun, Lai, Zhang, Tian and Ye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhengxu Ye, Department of Orthopaedics, Xijing hospital, Fourth Military Medical University, Xi'an, 710032, China
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