经Wiltse入路治疗胸腰椎骨折疗效观察  

Surgical treatment of thoracolumbar fractures through Wiltse approach

作　　者：任亚军[1] 张云庆[1] 周枫[1] 邓雄伟[1] 方剑峰[1] 骆文兴[1] 

机构地区：[1]东南大学附属江阴医院骨科,江苏江阴214400

出　　处：《临床骨科杂志》2014年第2期137-139,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨经Wihse入路椎弓根螺钉内固定治疗胸腰椎骨折的临床疗效。方法将68例无明显神经损伤的胸腰椎骨折患者随机分为Wiltse入路组（W组，32例）和传统后正中入路组（T组，36例），比较两种术式的手术时间、术中出血量、术后引流量、术前术后Cobb角、疼痛视觉模拟量表（VAS）评分。结果68例均获随访，时间8—60个月。无切口感染，脊柱生理弧度恢复满意，椎弓根螺钉位置良好，无断钉、断棒等发生。两组术后Cobb角均较术前改善（P〈0．05），两组之间术后各时段Cobb角比较差异无统计学意义（P〉0．05）；w组在手术时间、术中出血量、术后引流量、术后VAS评分明显优于T组（P〈0．05）。结论经Wiltse入路治疗胸腰椎骨折，手术时间短，创伤小，出血少，恢复快，疗效好。Objective To evaluate the clinical effects and advantages of Wiltse approach in treatment of thoracolum- bar fractures. Methods 68 thoracolumbar fractures without obvious nerve injury, were randomly allocated to receive instrumentation through Wiltse approach （Group W,32 cases） and traditional posterior midline approach （Group T, 36 cases）. The operation time, blood loss, postoperative drainage, preoperative and postoperative VAS score and chan- ges of Cobb angles were observed. Results 68 cases were followed up for 8 to 60 months. Reduction and screw posi- tion were satisfactory; infection and implant failure were not observed. The Cobb angle was improved in both groups （P 〈0.05）. Significant difference of changes of Cobb angles was not observed between the groups （P 〉 0. 05 ）, and the operation time, blood loss, postoperative drainage and VAS score was significant less in Group W （ P 〈 0.05 ）. Conclusions Treatment of thoracolumbar fractures through Wiltse approach can achieve the same reduction as through traditional posterior midline approach but with less operation time, less surgical trauma, less blood loss, quicker recovery and better effect.

关 键 词：胸腰椎骨折 Wiltse入路 椎弓根螺钉 多裂肌 最长肌 

分 类 号：R683.2[医药卫生—骨科学] R687.32[医药卫生—外科学]