Work

Enhancing long-term fixation in thoracolumbar injuries: From screw design to bone quality optimization

Year: 2025

Type: article

Abstract: contributes significantly to this discussion, identifying predictors of pedicle screw loosening such as low bone radiodensity, longer fixation constructs, and extensive decompression. Adjunctive strategies - auxiliary posterior fusion, anterior column reconstruction, and intermediate screw usage - support an individualized, biomechanically sound surgical plan. In this article, we explore the clinical relevance of these findings within spinal trauma care. We emphasize the role of preoperative bone quality assessment, including computed tomography-based Hounsfield unit analysis and magnetic resonance imaging-derived vertebral bone quality score, as modifiable predictors of long-term outcomes. We also discuss innovations in screw design, surface coatings, and patient-specific planning to reduce failure risk. Furthermore, emerging technologies such as finite element modeling and 3D-printed instrumentation may refine patient-specific strategies. By integrating biomechanical principles with personalized surgical planning, future approaches may enhance fixation durability. Ultimately, aligning mechanical stability with biological sustainability is critical to reducing implant failure in complex thoracolumbar trauma cases.

Source: World Journal of Orthopedics

DOI: 10.5312/wjo.v16.i12.112406

Authors: Musa Ergin, Süha A Aktaş

Institution: İstanbul Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi

Language: English

Topic: Spinal Fractures and Fixation Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: State Key Laboratory of Robotics