Effect of Modified Wiltse Approach for Pedicle Screw Internal Fixation in Curing Rehabilitation of Patients with Thoracolumbar Fractures Without Nerve Injury
Objective To explore the clinical effect of modified Wiltse approach pedicle screw internal fixation in curing the rehabilitation of patients with thoracolumbar fractures without nerve injury.Methods The clinical data of 80 patients with thoracolumbar fractures without nerve injury admitted to Puyang People's Hospital from January 2021 to January 2023 were retrospectively included.All the patients enrolled were treated with pedicle nailing,patient data treated with percutaneous pedicle approach were included in the control group(38 cases),and patients treated with modified Wiltse approach were included in the observation group(42 cases).The surgical index,sagittal plane Cobb angle of spine,relative height of the anterior edge of the injured vertebra,visual analogue score(VAS)and Oswestry dysfunction index(ODI)were compared between the two groups.Results The observation group had lower surgical time,intraoperative bleeding volume,and postoperative hospital stay compared to the control group(P＜0.05).In both groups,Cobb angle decreased at 1 and 3 months after the operation,and the relative height of the leading edge increased than before the operation,the time effect of Cobb angle and the relative height of the anterior edge was statistically significant(P＜0.05).The group and interaction effects of two groups were not statistically significant(P＞0.05).There were statistical significant differences in the inter group,time,and interaction effects between the two groups of VAS scores(P＜0.05).The VAS scores of the observation group were lower than those of the control group,and the VAS scores decreased compared to preoperative levels at one and three months after surgery(P＜0.05).The time effect of ODI index had statistically significance(P＜0.05).The ODI index decreased compared to preoperative levels at 1 and 3 months after surgery(P＜0.05).There was no statistical significant in the incidence of postoperative complications between two groups(P＞0.05).Conclusion The modified Wiltse approach and percutaneous pedicle screw internal fixation have the same effect in the treatment of patients with thoracolumbar fractures without nerve injury.Both approaches have higher safety.However,compared with the percutaneous approach,the modified Wiltse approach has shorter operation time,less intraoperative blood loss,and faster recovery of patients,which can alleviate the short-term postoperative pain of patients and promote the rehabilitation of patients.
万方数据
维普
