Objective  To study the feasibility and clinical therapeutic effect of internal fixation of thoracolumbar fractures with screws through the pedicle of fractured vertebral arch.   Methods  Clinical data about 67 single level thoracolumbar fracture patients admitted to our department from January 2005 to February 2009 were retrospectively analyzed. The patients were divided into 4-screw fixation group (n=45) and 6-screw fixation group (n=22). Simple trans-fractured vertebral fixation was performed for the fractures with 4 screws in 4-screw fixation group

and fractures in 6-screw fixation group were fixed with 6 screws through the pedical of fractured vertebral arch. The patients were followed up for 6-43 months (mean 12.6 months). The incision size

intraoperative blood loss

postoperative drainage

anterior and posterior margin height of fractured vertebra

Cobb’ angle

internal fixation failure

and postoperative complications were compared between the two groups.   Results  The difference in perioperative parameters

such incision size

intra-operative blood loss

postoperative hospital stay

except for postoperative drainage

was significant between the two groups (P0.05). However

no difference was found in postoperative parameters

such incision size

intra-operative blood loss

postoperative hospital stay (P0.05). Compared with before operation

the anterior and posterior margin height of fractured vertebra

Cobb’ angle

and posterior prominent angle were more significantly improved in 6-screw fixation group than in 4-screw fixation group after operation (P0.05). The incidence of exacerbated postoperative posterior prominence was 8.9% in 4-screw fixation group with a crew exit rate of 3.3%. However

no such events occurred in 6-screw fixation group.   Conclusion  Internal fixation of thoracolumbar fractures with screws through the pedicle of fractured vertebral arch can achieve better outcome in correcting the anterior and posterior margin height of fractured vertebral than traditional trans-fractured vertebral fixation

and is a practical and effective procedure for the fixation of thoracolumbar fractures.