Surgical outcomes of mini-open Wiltse approach and conventional open approach in patients with single-segment thoracolumbar fractures without neurologic injury  

作　　者：Haijun Li Lei Yang Hao Xie Lipeng Yu Haifeng Wei Xiaojian Cao 

机构地区：[1]Department of Orthopaedics,the First Affiliated Hospital of Nanjing Medical University [2]Department of Orthopaedics,the Second Affiliated Hospital of Nanjing Medical University [3]Department of Radiology,Taizhou People's Hospital affiliated to Nantong University

出　　处：《The Journal of Biomedical Research》2015年第1期76-82,共7页生物医学研究杂志（英文版）

基　　金：supported by the National Natural Science Foundation of China(Grant No.30973058, 81171694,and 81371968);the Program for Development of Innovative Research Team in the First Affiliated Hospital of NJMU(No.IRT-015);A Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions

摘　　要：This study aimed to introduce a novel mini-open pedicle screw fixation technique via Wiltse approach, and com- pared it with the traditional posterior open method. A total of 72 cases of single-segment thoracolumbar fractures without neurologic injury underwent pedicle screw fixation via two different approaches. Among them, 37 patients were treated using posterior open surgery, and 35 patients received mini-open operation via Wiltse approach. Crew placement accuracy rate, operative time, blood loss, postoperative drainage, postoperative hospitalization time, radiation exposure time, postoperative improvement in R value, Cobb＇s angle and visual analog scale （VAS） scores of the two methods were compared. There were no significant differences in the accuracy rate of pedicle screw placement, radiation exposure and postoperative R value and Cobb＇s angle improvement between the two groups. However, the mini-open method had obvious advantages over the conventional open method in operative time, blood loss, postoperative drainage, postoperative hospitalization time, and postoperative improvement in VAS. The mini-open pedicle screw technique could be applied in treatment of single-segment thoracolumbar fracture without neurologic injury and had advantages of less tissue trauma, short operative and rehabilitative time on the premise of guaranteed accuracy rate and no increased radiation exposure.This study aimed to introduce a novel mini-open pedicle screw fixation technique via Wiltse approach, and com- pared it with the traditional posterior open method. A total of 72 cases of single-segment thoracolumbar fractures without neurologic injury underwent pedicle screw fixation via two different approaches. Among them, 37 patients were treated using posterior open surgery, and 35 patients received mini-open operation via Wiltse approach. Crew placement accuracy rate, operative time, blood loss, postoperative drainage, postoperative hospitalization time, radiation exposure time, postoperative improvement in R value, Cobb＇s angle and visual analog scale （VAS） scores of the two methods were compared. There were no significant differences in the accuracy rate of pedicle screw placement, radiation exposure and postoperative R value and Cobb＇s angle improvement between the two groups. However, the mini-open method had obvious advantages over the conventional open method in operative time, blood loss, postoperative drainage, postoperative hospitalization time, and postoperative improvement in VAS. The mini-open pedicle screw technique could be applied in treatment of single-segment thoracolumbar fracture without neurologic injury and had advantages of less tissue trauma, short operative and rehabilitative time on the premise of guaranteed accuracy rate and no increased radiation exposure.

关 键 词：thoracolumbar fracture pedicle screw MINI-OPEN Wiltse approach minimally invasive 

分 类 号：R687.3[医药卫生—骨科学]