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OBJECTIVETodevelopanewtechniquebycombiningsimplifiedpercutaneousexternalpedicularfixatorwithintracorporealbonegraftingtotreatthoracolumbarfracturesandassessitstechnicalsafetyandclinicalefficacy.SUMMARYOFBACKGROUNDDATAForsurgicaltreatmentofthoracolumbarfractures,theclassicaltechniquesarebeneficialindecompression,restoration,fixation,andgraftfusion,buttheyarealsohugelyinvasiveprocedures.Theearlierexternalspinalfixationproceduresaregoodatindirectrestoration,decompression,andelasticfixationofspinalfracture.However,theyarelimitedbyremainsofalargeexternalframeandinabilityofvertebralreconstruct.Therefore,theminimallyinvasivetechniquescombiningsimplifiedpercutaneousexternalpedicularfixationandintracorporealbonegraftingmightbeausefulalternative.METHODSTherewere50consecutivepatientswhohadthoracolumbarfractureswithorwithoutassociatedincompleteneurologicdeficit.Theyunderwentpercutaneousexternalpediclefixationandintracorporealbonegraftingsurgerywithin7daysofadmission,hadtheirimplantsremovedafter3months,andwereprospectivelyfollowedforatleast12months.AmericanSpineInjuryAssociationgrading,spinalcanalencroachment,spinalCobbangle,andvertebralbodyheightwerecalculatedbeforeandaftersurgeryto assessclinicaloutcome.RESULTSAminimumof12-monthfollow-upwasachievedin50patients.Theaverageoperativetimewas90minutes(range,50-160 minutes).Themeanbonegraftvolumewas4.8cm(range,3.2-10.6cm).Theintraoperativemeanbloodlosswas100mL(range, 50-180mL).Forty-twopatientsallhadatleastoneAmericanSpineInjuryAssociationgradeneurologicimprovementonfinal follow-upobservation;therewerenosurgery-relatedcomplications.Themeananteriorheightofvertebralbodywas53.2%(range25%-78%)beforesurgery,93.6%(range78%-104%)aftersurgery,and94%(range79%-103%)atfinalfollow-up.ThepreoperativeCobbangleoftheprimarycurveaveraged30.7°(range8°-67°),andcorrectedto4.5°(range0°-12.0°)immediatelyaftersurgery,Therewerestatisticallysignificant(P0.01)amongthembeforeandafteroperation.Therewasnoinstrumentationfailureormeasurablelossofsagittalcurveandvertebralheightcorrectioninanycases.CONCLUSIONThenewtechniquebycombinationofpercutaneousexternaltranspedicularfixationandtranspedicularbonegraftingisafeasible,safe,useful,efficient,andminimallyinvasivemethodtotreatthoracolumbarfractures.Itisareasonablealternative methodtootherminimallyinvasivetechniquesofsurgicalmanagementofthethoracolumbarfractures.