[Development and clinical application of elastic trephine through pedicle of fractured vertebra]

To evaluate the feasibility and surgical procedure of bone grafting with elastic trephine.

A total of 42 cases of thoracolumbar fracture received pedicle screw fixations by combining bone grafting with elastic trephine through pedicle of fractured vertebra. The ratios of the altitude of traumatic vertebra to normal altitude, kyphosis Cobb angle and sagittal index were measured by preoperative and postoperative X-ray images.

A follow-up visit of 12-26 months (average: 14.8) showed that the dislocations of vertebrae were corrected and fusions completed. Proportion of the height of anterior edge of traumatic vertebra to normal height was (53.89 ± 6.57)% at pre-operation, (92.31 ± 11.25)% at post-operation and (91.39 ± 10.28)% at an one-year follow-up (P < 0.05). The kyphosis was (23.19 ± 5.74)° Cobb angle at pre-operation, (4.92 ± 1.03)° at post-operation and (5.13 ± 1.41)° at an one-year follow-up (P < 0.05). In contrast with 86% (78%-97%) on average at post-operation, the pre-operative sagittal index was 54% (32%-66%) on average.

Application of bone grafting with elastic trephine can reconstruct the altitude of injured vertebral body, increase the compressive stability of anterior column as well as effectively correct the kyphosis deformity. With a convenient application, elastic trephine plays a variety of roles in both auxiliary reduction and bone grafting reconstruction.