Clinical Study Of Percutaneous Vertebral Body Bone Grafting In The Treatment Of Thoracolumbar Fractures

Objective: To investigate the clinical effect of percutaneous vertebroplasty(PVP)with bone grafting instead of bone cement in the treatment of thoracolumbar compression fracture(TLCF)without nerve defect.Methods: This study collected from December 2014 to February 2016 for thoracolumbar compression hospitalized parallel percutaneous vertebral body bone graft angioplasty in the treatment of patients with a total of 36 cases in our hospital department of orthopedics fracture,there were 21 males and 15 females,mean age 43.5 ±9.3(19~64)years old.Neurological function according to Frankel classification,all is E class.Fracture segment:T12 combined with L1 in 1 cases,T11 in 6 cases,T12 in 10 cases,L1 in 12 cases,L2 in 6cases,L3 in 1case.Fracture type: simple compression fracture.Preoperative computed bone quantity,operation time,bleeding volume and bone graft were recorded,respectively on preoperative and postoperative 3 days,3 months,6 months after surgery,postoperative patients were followed for 1 years,obtained the degree of pain,X-ray and CT or MRI data.The VAS score,the height of anterior vertebral body height(AVH%)and the angle of kyphosis(Cobb’angle)were obtained at each follow-up point of the patients,and statistical analysis was performed to evaluate the clinical effect.Results: The patients were followed up for an average of 14 months(12-20 months).The average operation time was 55 min,the average blood loss in operation was 12 ml,and the average bone graft volume was 8.7±1.2 g(8~10g).The degree of pain improvement:VAS score decreased from 7.3±0.9 to 2.8±0.6,at the time of 3 month was 2.0±0.5,at the time of 6 months was 1.4±0.5,at the time of 1 year was 1.1±0.5.Anterior vertebral height and Cobb’angle,anterior vertebral height ratio(AVH%)after 3 days from preoperative62.8% ±3.4% recovered to 90.4% ±3%,at the time of 3 month was 88.1%±2.9%,6months,87.3%±2.9%,1 years 87.0%±2.9%.Cobb’angle 3 days after surgery from18.6±2.5° down to 3.5±0.6°,at the time of 3 months was 4.8±0.9°,at the time of 6months was 5.1±0.9°,at the time of 1 year was 5.4±0.9°.All the patients had good bone healing,no neurological impairment,no intractable back pain,no progressive kyphosis,and other complications.Conclusion: The injury of thoracolumbar vertebral compression fractures in patients without nerve,the complete structure of percutaneous vertebral body bone graft angioplasty can effectively restore vertebral stability,early can effectively alleviate vertebral pain,reduce the bed and rehabilitation exercise in patients with painful vertebral body full of impaction bone grafting in restoring and maintaining vertebral height at the same time to avoid the "shell like" vertebral body,thereby reducing the occurrence of progressive kyphotic deformity,intractable back pain and other complications.Percutaneous vertebral body bone grafting has the advantages of less trauma,high safety and less complications,and is a safe and effective minimally invasive surgical treatment.