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Abstract Objective To investigate the clinical effect of posterior short segmental pedicle screw fixation combined with transpedical bone grafting in the treatment of unstable thoracolumbar vertebral fracture.Methods From January 2013 to January 2016，25 cases of unstable thoracolumbarvertebral fractures were treated with posterior short segmental pedicle screw fixation combined with transpedical bone grafting.This group was set up for the observation group.Another 25 unstable thoracolumbarvertebral fractures cases were retrospectively analyzed prior to December 2012.In those cases，which was set up for control group，the operation method was posterior long segmental (8 transpedical screw) fixation crossing the injured vertebrae.Both groups of patients were type A3 in AO classification and single vertebral body fracture.The VAS score of lumbar back pain，the ratio of the anterior edge height of the injured vertebra，the sagittal Cobb Angle，the nerve function before and after the operation and the incidence rate of empty shell in the injured vertebra were compared statistically between the two groups.Results The two groups were followed up for 12~16 (14.5±2.9) month.There were significant improvements in the anterior edge height of the injured vertebra，the sagittal Cobb Angle and the nerve function in both groups after surgery，and the difference was statistically significant (P＜0.05). However，there was no statistically significant difference between the two groups (P＞0.05).The incidence rate of hollow shell in the injured vertebral body in the experimental group was smaller than that in the control group，and the difference was statistically significant (P＜0.05).There was no pedicle screw or rod breaking in the experimental group，but one case suffered rod breakage in the control group one year after surgery.Conclusion It is safe and effective to treat unstable thoracolumbar vertebral fractures with posterior short segmental pedicle screw fixation combined with transpedical bone grafting.Meanwhile，it can effectively restore the height of injured vertebral column，promote the primary healing of injured vertebral body，reduce the occurrence of empty shell in injured vertebral body and rebuild the mechanical stability of spine.
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