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14th century, Guy de Chauliac invented the dental pelican, which was used through the late 18th century. If an injured vertebral body diastasis hinders bony union, increases secondary fragment dislocation risk, and also interrupts bony tissue trophic, it is entirely possible that there can be some complications in transpedicular fixation:  posttraumatic osteonecrosis (Kummel disease), false joint formation and posttraumatic pathological kyphosis recurrence.
Therefore we suggested “Reduction of spinal comminuted fractures method” and a useful model for realization [7]. The principle of the method is that transpedicular bone screws are administered into spondyles adjacent to an injured one under C-arm control. During control observing implanted system was stable, there was no pathological kyphosis, spinal canal was intact (Figures 3a and 3b). Simplicity of its technical operation and the technique efficiency in surgical treatment of vertebral body comminuted fractures makes it possible for practical use. Khirurgicheskoe lechenie patsientov s povrezhdeniyami pozvonochnika grudnoi i poyasnichnoi lokalizatsii [Surgical treatment in patients with thoracic and lumbar spine injuries]. Khirurgicheskiye metody v komplekse lecheniya povrezhdeniy grudnogo i poyasnichnogo otdelov pozvonochnika [Thoracic and lumbar spine injuries complex surgical treatment]. Povrezhdeniya pozvonochnika i spinnogo mozga (mekhanizmy, klinika, diagnostika, lechenie) [Spinal and spinal cord injuries (mechanisms, clinics, diagnostics, treatment)]. Zueva – MD, PhD, Scientific Assistant, Department of New Technologies in Vertebrology and Neurosurgery, Saratov Scientific Research Institute of Traumatology and Orthopedics, Saratov, Russia. Then bone thread cutter 2 (Figure 1a) is administered into a ventral fragment1 of an injured vertebra (Figure 1). After 2 weeks the patient is discharged from hospital in satisfactory condition under the care of traumatologist.


During the passage of the bone thread cutter in horizontal plane declivity angles should be kept: 5-10° is for lower thoracic spine, 15° is for lumber spine. During an X-ray imaging the L1 vertebral body compression and comminuted fracture (Figure 2а) has been revealed. There is no further advance of a bone thread cutter behind 2 ventral fragment 1 vertebral cortical rim because of a dynamic limiter 3. This is the method of transpedicular fixation of injured and intact approximal vertebrae.  Then bone screws are administered into the injured vertebral body through its vertebral arch roots which reduces secondary fragment dislocation risk.
Next, keeping on twisting a bone thread cutter 2, dynamic compression is produced which is important for ventral fragment reposition 1 (Figure 1b).
Denis classification), and as a result big vertebral body ventral fragment formed (Figure 2b). Nevertheless using this method it is impossible to use reduction of injured vertebra body fragments. After that through the Roy-Kamilla contralateral point 4 (Figure 1b) and a channel formed by bone thread cutter the bone screw 5 is administered. Because of the revealed pathology there was a surgical treatment using the suggested method.
After posterior surgical approach there have been by two bone screws administered into Th12 and L2 spondyles. The surgery is presented by transpedicular fixation of an injured part and allows reduction of injured vertebra body fragments.
Then bone thread cutter should be removed 2 and another bone screw is administered into a channel 6 (Figure 1d).


Then the bone thread cutter has been administered from the left into L1 vertebral body ventral fragment. Simplicity of its technical operation and the technique efficiency confirms its practical value. After all these procedures are performed a complete transpedicular system mounting should be made.
The bone thread cutter limiter is fixed up at an equal distance to linear dimension of a vertebral body from neural arch root of vertebra to ventral cortical rim.
Next under C-arm control dynamic compression successive bone thread cutter twisting is performed until ventral fragment reposition is done. Such injuries are from the category of the severest traumas, the most of the injured become disabled for a long period of time [1].
Over the last years surgical methods are getting more popular in backbone injuries treatment [2]. These methods, as usual, let patients get rid of a long bed rest and give a chance to achieve full functional rehabilitation [3].
Transpedicular fixation system [4] is widely brought to use in unstable thoracic spine and lumber spine injuries (it is often vertebral body comminuted fractures).



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