Comparison of the effects of Wiltse approach and minimally invasive percutaneous approach in the treatment of thoracolumbar fracture patients without neurological deficit
- VernacularTitle:经皮椎弓根螺钉与Wiltse入路复位内固定术治疗无神经症状胸腰椎骨折的疗效对比
- Author:
Bobo ZHANG
1
;
Zhongwei SONG
2
;
Qiaoling LI
3
;
Yimin YANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Wiltse approach; percutaneous approach; thoracolumbar fracture; minimally invasive
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(1):57-62
- CountryChina
- Language:Chinese
- Abstract: 【Objective】 To compare the clinical efficacy of minimally invasive percutaneous approach with Wiltse approach in the treatment of thoracolumbar fracture without neurological deficit in young and middle-aged patients. 【Methods】 A prospective study was conducted in 108 patients with thoracolumbar fracture without neurological symptoms treated in Department of Orthopedics， The First Affiliated Hospital of Xi’an Jiaotong University from March 2015 to March 2018. We randomly assigned 54 patients to minimally invasive percutaneous approach group （Group A） and 54 ones to Wiltse approach group （Group B）. We compared the operation time， intraoperative blood loss， incision length， the number of intraoperative fluoroscopy times， and postoperative hospital stay of Group A and Group B. We also compared the VAS scores of the two groups before and 3 days after surgery and at each review， the vertebral frontal height compression ratio and Cobb Angle before and immediately after surgery， 3 months 1 year and 3 years after surgery， and ODI index before surgery and 3 months， 1 year and 3 years after surgery. 【Results】 All the 108 patients were followed up. There were no significant differences in operation time， intraoperative blood loss or postoperative hospital stay between the two groups （P>0.05）. The number of intraoperative fluoroscopy times was significantly smaller in Group B than in Group A （P<0.05）， and the incision length was shorter than that in Group A （P<0.05）. The two groups did not significantly differ in VAS score or ODI index before operation （P>0.05）， after operation， or at follow-up， while the anterior vertebral body height ratio and Cobb angle were significantly lower in Group B than in Group A （P<0.0125）. 【Conclusion】 Minimally invasive percutaneous approach and Wiltse approach are both safe and effective in the treatment of thoracolumbar fracture without neurological deficit. However， the number of intraoperative fluoroscopy times of Wiltse approach was significantly reduced， the incision length was smaller than that of the percutaneous pedicle group， and the postoperative anterior vertebral compression rate and Cobb Angle were lower than those of the percutaneous group， indicating better clinical efficacy.
