The Clinical Indication Of The Percutanous External Spinal Fixation Associated PVP And The Clinical Application Of Vertebral Body's Slurry

Thoracolumbar fracture is a kind of common surgical trauma.Orthodox treat-method mainly is internal fixation,but the method has many shortcomings ,such as macro- trauma,stress concentraction,stress blocking,et al.In order to overcome these shortcoming,we designed a new percutanous external spinal fixation. The percutanous external spinal fixation has satisfactory biomechanics stability. The mini-invasion technique of the PETF associated Percutaneous vertabroplasty(PVP) or/and microendoscopy could be as a selective choice for thoracolumbar fracture.Part TwoThe clinical indication of the new percutanous external spinal fixation associated Percutaneous vertabroplasty(PVP) in thoracolumbar fracture treatmentObjective: To explore the clinical indication of the new percutanous external spinal fixation associated Percutaneous vertabroplasty(PVP) in treating thoracolumbar fracture.Method: Seventy-eight patients with thoracolumbar fracture were classified into compress fracture and burst fracture according to whether or not involvement of the vertebral body's posterior wall.Thirty patients with compress fracture were treated by the mini- trauma technique of the PETF associated Percutaneous vertabroplasty(PVP). Forty-eight patients with burst fracture were classificated into four types according to bone fracture's patho-shape,spinal stenosis index and nerve function. The forty-eight patients with burst fracture were treated by the mini- trauma technique of the PETF associated Percutaneous vertabroplasty(PVP) or/and microendoscopy .Result: All cases were followed up for average 9 months.All cases were primary healing,the preoperative symptoms were improved satisfactorily.there were no neural injury was observed,except three cases suferring bolt- hole infection.Conclusion: The clinical outcome of the percutanous external spinal fixation assistanted Percutaneous vertabroplasty(PVP) was satisfactory with right indication and reasonable classification,and the minially invasive method could be as a selective choice for thoracolumbar fracture.Part Three The clinical application of the three kinds of vertebral body's slurry in thoracolumbar fracture mini- trauma treatment Objective: To evaluate the clinical outcome of the three kinds of vertebral body's slurry in thoracolumbar fracture treatment.Method: Seventy-eight patients with thoracolumbar fracture were classified into three groups according to selecting three kinds of vertebral body's slurry. The three kinds of vertebral body's slurry are polymethylmethacrylate (PMMA),calcium phosphate cement (CPC) and autogenous bone. The clinical curative effects of the three kinds of vertebral body's slurry were evaluated according to the vertebral body's bone union state,the vertebral body's height-loss and adverse reaction incidence.Result: All cases were primary healing, there were no neural injury was observed. The adverse reaction incidence: PMMA>CPC>autogenous bone. The vertebral body's bone union state: CPC < autogenous bone. The vertebral body's height-loss of the three groups have no significant difference.Conclusion: In the vertebral body's slurry in thoracolumbar fracture treatment, autogenous bone mainly refer to no osteoporosis cases; PMMA mainly refer to osteoporosis cases; CPC also refer to no osteoporosis cases.