Clinical Application Of The New External Spinal Skeletal Fixation In Multi-segmental Thoracolumbar Fractures

Objective To investigate the clinic outcome of multi-segmental thoracolumbar fractures without obvious neurological dysfunction after new external spinal skeletal fixation and percutaneous vertebral bone graft.Method Between September 2010 and March 2017,there were 28 patients with multi-segmental contigous spinal fracture(MCSF) underwent new external spinal skeletal fixation and percutaneous vertebral bone graft.17 men and 11 women had a mean age of 37.5 years old at the time of surgery.And there were 28 patients with multiple-segmental noncontigous spinal fracture(MNSF) underwent new external spinal skeletal fixation and percutaneous vertebral bone graft.16 men and 12 women had a mean age of 38.3 years old at the time of surgery.Record the follow-up period,ASIA grade,X-ray,CT and MRI of pre-operation,post-operation and the last follow up,and record X-ray,CT of post-operation and the last follow up.Measure the change of percentage of anterior vertebral height.Calculate the VAS score of preoperative,post-operation and the last follow-up.Results:The follow-up period of 28 MCSF patients was 13~32 months(24.5±3.5 months).By ASIA scale,there were 3 patients with D grade nerve function preoperative recover to E grade after surgery;the mean percentage of anterior vertebral height of preoperative,post-operation and the last follow-up were respectively 67.1±5.9%?90.4±2.3%?89.2±2.4%,and the statistics show that P < 0.05 when compared between preoperative and each time after surgery,the statistics show that P>0.05 when compared between post-operation and the last follow-up;the VAS score of preoperative,post-operation and the last follow-up were respectively 8.1±1.0,2.4±0.8,0.5±0.5,the scores showed a gradually declining trend,and the statistics show that P < 0.05 when compared between preoperative and each time after surgery.The follow-up period of 28 MNSF patients was 9?60 months(24.7±7.5 months).By ASIA scale,there were 5 patients with D grade nerve function preoperative recover to E grade after surgery;the mean percentage of anterior vertebral height of preoperative,post-operation and the last follow-up were respectively 62.9±6.1%?92.4±1.8%?91.7±1.9%,and the statistics show that P < 0.05 when compared between preoperative and each time after surgery,the statistics show that P>0.05when compared between post-operation and the last follow-up;the VAS score of preoperative,post-operation and the last follow-up were respectively 7.5±1.1,2.7±0.8,0.7±0.7,the scores showed a gradually declining trend,and the statistics show that P < 0.05 when compared between preoperative and each time after surgery.Screw loosening occurred in 2 cases and nail tracker infection occurred in 2 patients.Both of them were removed the external spinal skeletal,and on other complications were found.Conclusions:The effect of multi-segmental thoracolumbar fractures without obvious neurological dysfunction after new external spinal skeletal fixation and percutaneous vertebral bone graft got satisfactory clinical effect.By strictly controlling the indications of surgery,which is an effective method of minimally invasive surgery.