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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2025; 16(12): 112406
Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.112406
Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.112406
Enhancing long-term fixation in thoracolumbar injuries: From screw design to bone quality optimization
Musa Ergin, Department of Orthopaedics and Traumatology, Cihanbeyli State Hospital, Konya 42850, Türkiye
Süha A Aktaş, Department of Orthopedics and Traumatology Clinic, Istanbul Physical Therapy and Rehabilitation Training and Research Hospital, Istanbul 34020, Türkiye
Co-first authors: Musa Ergin and Süha A Aktaş.
Author contributions: Ergin M designed the overall concept and outline of the manuscript; Aktaş SA contributed to the discussion and design of the manuscript; Ergin M and Aktaş SA contributed to the writing, and editing the manuscript, and review of the literature, they contributed equally to this article, they are the co-first authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Musa Ergin, Department of Orthopaedics and Traumatology, Cihanbeyli State Hospital, Hastane Cd. No. 61 Cihanbeyli, Konya 42850, Türkiye.
Received: July 28, 2025
Revised: August 17, 2025
Accepted: October 20, 2025
Published online: December 18, 2025
Processing time: 144 Days and 18 Hours
Revised: August 17, 2025
Accepted: October 20, 2025
Published online: December 18, 2025
Processing time: 144 Days and 18 Hours
Core Tip
Core Tip: This article highlights key factors influencing long-term pedicle screw stability in thoracolumbar fractures, including bone quality, construct length, and decompression extent. Practical strategies such as computed tomography-based Hounsfield unit and magnetic resonance imaging-based vertebral bone quality score assessment, the use of intermediate screws, and anterior column reconstruction are discussed. Technological advances like coated implants and patient-specific planning are emphasized to enhance long-term outcomes. Integration of these approaches may help reduce implant failure in complex spinal trauma cases.