Double Index Screw Fixation Improves Radiological Outcomes in Thoracolumbar Burst Fractures: Study

The key findings of the study were:

• The mean age in the SIS group was 43.7 years (range 19–58 years) and the DIS group was 48.5 years (range 17–55 years).

• The mean follow-up period in both groups was 29.5 months (range 24–96 months).

• The fractures were operated within 72 h in most patients (84.4%) with the maximum interval between injury and surgery being 34 days.

• The radiological parameters between both groups showed significant differences in terms of CA, VWA, and VBCR at the latest follow-up (SIS: 12.5°, 15°, 80.1% vs DIS: 8.04°, 11.2°, 87.1%) (p < 0.05).

• VAS and ODI were better in the DIS group but were statistically insignificant (p > 0.05).

The authors concluded - “Fixation of unstable thoracolumbar fractures with short-segment posterior stabilization with double-index screws (DIS) in the fractured vertebra resulted in radiologically better maintenance of CA, VWA, and VBCR compared to single index screw (SIS). Though the VAS and ODI were better in the DIS group, it was found to be statistically insignificant. There was no difference in spinal canal remodeling and neurological recovery in both groups.”

Further reading:

Single vs Double Index Screws in Thoracolumbar Burst Fractures: A Retrospective Analysis Vinoth Thangamani et al Indian Journal of Orthopaedics (2025) 59:1265–1273 https://doi.org/10.1007/s43465-025-01433-2