Application value of a novel tappable bone grafting tool with variable angle lateral window in short-segment fixation via intermuscular approach for thoracolumbar fractures.

OBJECTIVE

To investigate the clinical application value of a novel tappable, lateral-hole, variable-angle bone grafting tool for injured vertebra bone grafting combined with screw placement in the injured vertebra, in the context of short-segment fixation via an intermuscular approach for thoracolumbar fractures.

METHODS

A retrospective study was conducted on 74 patients treated between January 2022 and June 2024. Patients were divided into three groups: Group A (n = 25) received conventional bone grafting without screw placement in the injured vertebra; Group B (n = 26) received conventional bone grafting with screw fixation; Group C (n = 23) received grafting with the novel tool plus screw fixation. Vertebral kyphosis angle (VKA), local kyphosis angle (LKA), superior endplate displacement (SED), Visual Analog Scale (VAS) scores, and complications were analyzed preoperatively, postoperatively, and at 3-month follow-up. Bone defect volume in Groups B and C was assessed using Mimics software on CT 3D reconstructions.

RESULTS

There were no significant differences in sex, age, operative time, or hospital stay among the three groups (P > 0.05). Preoperative and 1-week postoperative VAS scores were similar among the groups (P > 0.05). At 3 months postoperatively, VAS scores in Group C were significantly lower than in Groups A and B (P < 0.05). Groups B and C exhibited significantly less loss of vertebral kyphosis angle (VKAloss) compared to Group A (p = 0.011). There were no significant differences in LKA among the three groups before surgery, after surgery, or at the 3-month follow-up (P > 0.05). Changes in SED values before and after surgery were consistent with VKA, and the SEDloss value in Group C was significantly lower than in Groups A and B at 3 months postoperatively (p < 0.001). Compared to Group B, Group C showed a significant reduction in fracture defect volume at 3 months postoperatively (p = 0.006).

CONCLUSION

The novel bone grafting tool provides effective vertebral support with high grafting efficiency, reduced pedicle damage, and improved postoperative outcomes. Its ease of use makes it a valuable addition to thoracolumbar fracture treatment via the intermuscular approach.