• Xiaoyuan He, Zhenhao Zhong, Wenjie Zhou, Shasha Guo, Huanxiong Chen, and Tao Chen.
• Department of Spinal Surgery, The First Affiliated Hospital of Hainan Medical University, (Hainan Province Clinical Medical Center), Haikou City, China.
• Medicine (Baltimore). 2023 Sep 22; 102 (38): e34830e34830.

BackgroundWe did this network meta-analysis to comprehensively compare the efficacy of different segments [intermediate segment (IS), short segment (SS) and long segment (LS)] in the fixation of thoracolumbar fractures.MethodsWe searched studies from inception until January 20, 2023 through PubMed, Embase, Web of Science, and the Cochrane Library. All studies comparing different segments in the fixation of thoracolumbar fractures were included in this meta-analysis. Outcomes were anterior vertebral height ratio (AVHR), sagittal Cobb angle (SCA), visual analogue scale score, and implant failure rate. This network meta-analysis was performed by R software with gemtc package.ResultsFinally, a total of 22 studies were finally included in this network meta-analysis. IS (WMD 2.43, 95% CrI 2.04-2.91) was more effective than SS in terms of the AVHR, and the difference was statistically significant. IS was more effective than LS in reducing SCA (WMD -2.87, 95% CrI -3.79 to -1.96) with statistically significant. Compared with SS, IS significantly reduced the SCA with statistically significant (WMD -2.52, 95% CrI -3.31 to -1.72). IS (WMD -2.87, 95% CrI -3.78 to -1.96) was more effective than LS, and the difference was statistically significant. Moreover, IS (WMD -2.52, 95% CrI -3.31 to -1.72) was more effective than SS, and the difference was statistically significant.ConclusionIS was associated with a significant reduction in SCA, implant failure rate, and visual analogue scale compared to SS and LS, while having the most favorable impact on AVHR among all the treatments assessed.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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