Technique of thoracic pedicle screw fixation for trauma

Thoracic fractures after trauma can lead to devastating neurological injury because of the close relationship among spinal cord, nerve roots, and their bony surroundings. Transpedicular fixation using pedicle screws in the thoracic spine is technically challenging but can be done safely and effectively if surgeons understand the complex anatomy of the region and adhere to biomechanical principles. This article discusses different approaches for placing pedicle screws in the thoracic spine and presents some case examples that demonstrate the technique. Surgeons involved with the operative management of spine trauma should become familiar with the placement of thoracic pedicle screws. The technique requires a thorough understanding of the anatomy of the region and the techniques used for placing instrumentation.