Wiltse入路、传统后正中入路椎弓根钉固定术治疗胸腰段脊柱骨折的疗效比较  

Comparison of the Curative Effect Between Pedicle Screw Fixation Through Wiltse Approach And TraditionalPosterior Median Approach for Thoracolumbar Spinal Fractures

作　　者：吴韬韬 赵茂[1] 曾祥聪 文军[1] 杨洋[1] WU Taotao;ZHAO Mao;ZENG Xiangcong;WEN Jun;YANG Yang(Xuyong County People's Hospital,Luzhou 646400,China)

机构地区：[1]叙永县人民医院,四川省泸州市646400

出　　处：《实用心脑肺血管病杂志》2020年第S01期86-88,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探究Wiltse入路、传统后正中入路椎弓根钉固定术治疗胸腰椎(T10~L2)段脊柱骨折的疗效,并进行比较。方法选取2018年2月—2019年1月收治的T10~L2段脊柱骨折患者76例,随机分为对照组及Wiltse组,各38例。对照组行后正中入路椎弓根钉固定术;Wiltse组行Wiltse入路椎弓根钉固定术。比较两组患者的手术基本情况,术前、术后肌酸磷酸激酶(CK)水平,术后疼痛模拟量表(VAS)评分。结果Wiltse组患者的手术时长、术中出血量、术后引流量、首次下床活动时间、术后住院天数均显著低于对照组(P<0.05);Cobb角纠正率显著高于对照组(P<0.05);术后1d、术后2d、术后7d Wiltse组患者的CK水平均显著低于对照组(P<0.05);术后1d、30d、60d、末次随访Wiltse组患者的VAS评分均显著低于对照组(P<0.05)。结论Wiltse入路较传统后正中入路椎弓根钉固定术治疗T10~L2段脊柱骨折的手术效果更好,伤口更小、恢复更快,有效减轻患者痛苦。Objective To comparatively study the curative effect of pedicle screw fixation throughWiltse approach and traditional posterior median approach in the treatment of thoracolumbar(T10~L2)spinal fractures.Methods A total of 76 patients with T10~L2 spinal fracturestreated between February 2018 and January 2019 were randomly divided into the control group and the Wiltse group,with 38 cases in each group.The control group were treated with pedicle screw fixation through posterior midline approach and the Wiltse group were treated with pedicle screw fixation throughWiltse approach.The basic surgical conditions,creatine phosphokinase(CK)levels before and after surgery and postoperative pain visual analogue scale(VAS)scores were compared between the two groups.Results The duration of surgery,intraoperative blood loss,postoperative drainage volume,the leaving bed time and postoperative hospital stay of Wiltse group were significantly shorter than those of the control group(P<0.05).The correction rate of Cobb angle was significantly higher than that in the control group(P<0.05).The CK levels in Wiltse group were significantly lower than those in the control group at 1 day,2 days and 7 days after surgery(P<0.05).VAS scores of Wiltse group at 1 day,30 days,60 days and the last follow-up were significantly lower than those of the control group(P<0.05).Conclusion The Wiltse approach is more effective than the traditional posterior median approach for pedicle screw fixation of T10~L2 spinal fractures.The former is with smaller wounds and faster recovery,and it can effectively reduce patient's suffering.

关 键 词：Wiltse入路 传统后正中入路 椎弓根钉固定术 胸腰段脊柱骨折 

分 类 号：R687.3[医药卫生—骨科学]