Background: Thoracolumbar fractures account for 60-75% of spinal injuries, often from falls or trauma, with neurological deficits in up to 40% of cases. Open pedicle screw fixation restores stability but risks blood loss, infection, and muscle damage. Minimally invasive surgery (MIS) pedicle screw techniques reduce these complications while achieving similar alignment and fusion. Data from resource-limited settings like Bangladesh are scarce. This study evaluates MIS outcomes in such a cohort.

Objective: Traumatic thoracolumbar fractures are common, and surgical fixation remains a cornerstone for achieving spinal stability and preserving neurological function. Minimally invasive surgery (MIS) pedicle screw fixation has emerged as a promising alternative to open approaches. This study evaluates the epidemiology, management, and outcomes of patients treated with MIS pedicle screw fixation for traumatic thoracolumbar fractures in our neurosurgical department.

Materials and Methods: This retrospective cohort study included all patients undergoing MIS pedicle screw fixation for thoracolumbar fractures between July 2023 and June 2025 at our institution.

Results: Thirty patients were included (21 males, 9 females; mean age 35 years). Most injuries resulted from falls. Fractures involved the thoracic spine in 15 cases (50%), lumbar spine in 10 (33%), and thoracolumbar junction in 5 (17%). Neurological deficits were present on admission in 12 patients (40%), with 9 (75%) showing postoperative improvement. Mean hospital stay was 6 days. All patients achieved satisfactory postoperative regional sagittal alignment. Most reported no or mild pain and good functional outcomes.

Conclusions: MIS pedicle screw fixation is a safe, effective option with outcomes comparable to open surgery and reduced perioperative morbidity. It yields rapid improvements in pain, Frankel grade, functional status, and regional sagittal alignment.