Transpedicular fixation of the lower spine for traumatic deformity

Objective: To evaluate the effectiveness of transpedicular fixation in traumatic deformity of the lower spine based on clinical and instrumental examination methods.

Material and Methods: The study included 37 patients with traumatic deformities of the lower thoracic and lumbar spine, who were treated in the neurosurgical department of the “Shifobakhsh” Medical Center in the Republic of Tajikistan from 2022 to 2025. Among them were 12 women (32.4%) and 25 men (67.6%). Patients’ age ranged from 19 to 54 years. All patients underwent surgical intervention: transpedicular fixation of the damaged spinal segments under radiographic control. Diagnostic evaluation included spinal radiography in two projections, computed tomography (CT) to assess the nature of the fracture and monitor screw position, magnetic resonance imaging (MRI) to visualize the spinal cord and soft tissue structures, pain assessment using the visual analogue scale (VAS), and neurological status assessment using the Frankel scale.

Results: Preoperatively, all patients experienced severe pain, with an average VAS score of 7.2±1.1 points. Postoperatively, the score was 2.8±0.9 points, indicating a significant reduction in pain. 24 patients with partially preserved spinal cord conduction demonstrated positive neurological changes, including movement in the lower extremities and resolution of pelvic disorders.

Conclusion: Transpedicular fixation is a reliable and effective surgical treatment for traumatic deformities of the lower spine. The use of X-ray, CT, and MRI allows for precise determination of the nature of the injury and optimization of screw placement. Patients with preserved spinal cord conduction experience a significant reduction in pain and improvement in neurological status. In cases of severe neurological impairment, surgery is justified from an orthopedic perspective to stabilize the spine. The main technical complication remains malposition of pedicle screws (10.8% of cases), which requires careful intraoperative monitoring.

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