Comparison of Preoperative Postural Reduction versus Intraoperative Distraction Reduction on Radiographic and Clinical Outcomes in Posterior Short-Segment Fixation for AO A3/A4 Thoracolumbar Fractures

Prospective stratified randomized controlled study: comparison of imaging and clinical outcomes between preoperative positional reduction and intraoperative open reduction in posterior short segment fixation of AO A3/A4 thoracolumbar fractures

Status

Active, not recruiting

Phases

Phase 1

Study type

Interventional

Source

ChiCTR

Registry ID

ChiCTR2600128437

Enrollment

Unknown

Registered

2026-07-20

Start date

2026-08-01

Completion date

Unknown

Last updated

2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Thoracolumbar vertebral fracture

Interventions

Preoperative position reduction+intraoperative expansion reduction+internal fixation:After general anesthesia, the patient is placed in a standard prone hyperextension position. Soft pillows are padde

Intraoperative expansion reduction+internal fixation:The patient is first positioned in a standard prone position, and fluoroscopy is used to document the reduction achieved by positional maneuvering.

overdistraction beyond anatomical reduction is avoided to prevent excessive tissue stretching. If compression deformity cannot be corrected by distraction, further distracting maneuvers are discontinu

Eligibility

Sex/Gender

All

Age

18 Years to 60 Years

Inclusion criteria

Inclusion criteria: 1. Age range: 18-60 years old; 2. Fresh single segment thoracolumbar fracture (recommended T11-L2); 3. AO Spine classification is A3 or A4; 4. The time from injury to surgery is <= 10 days; 5. Suitable for posterior short segment internal fixation treatment; 6. The patient signs informed consent.

Exclusion criteria

Exclusion criteria: 1. Multi segmental spinal fractures; 2. Pathological fractures or significant osteoporotic fractures; 3. Patients with significant posterior ligament complex injuries requiring special reconstruction; 4. Those who require direct decompression or anterior reconstruction; 5. Previous history of thoracolumbar surgery; 6. Those with poor follow-up compliance or unable to complete the 12-month follow-up.

Design outcomes

Primary

Measure	Time frame
Loss rate of anterior edge height of injured vertebrae;	—

Secondary

Measure	Time frame
Postoperative immediate local kyphosis Cobb angle correction value;Recovery rate of anterior vertebral body height;Improvement rate of spinal canal space occupation;Fracture healing time;Internal fixation failure;reoperation rate;VAS score;ODI index;	—

Countries

China

Contacts

Public ContactTaoyi Cai

The 909th Hospital, School of Medicine, Xiamen University

ctyi175@163.com+86 596 293 1538

Outcome results

None listed

Source: ChiCTR (via WHO ICTRP) · Data processed: Aug 10, 2026