Clinical Study of Posterior Long Segment Pedicle Screw Fixation Combined with Limited Interlaminar Decompression through Wiltse Paraspinal Approach for Thoracolumbar Burst Fractures
Objective To compare the clinical efficacy of long segment pedicle screw fixation combined with limited decompression between the Wiltse paraspinal approach and traditional open approach for the treatment of thoracolumbar burst fractures.Methods Clinical data of 42 patients with thoracolumbar burst fractures undergoing long segment pedicle screw fixation combined with laminectomy decompression from January 2019 to March 2022 in the Third Department of Orthopedics of General Hospital of Ningxia Medical University were retrospectively studied.Among them,20 cases underwent posterior long segment pedicle screw fixation through Wiltse paraspinal approach combined with minimal invasive laminectomy decompression(Mini-group),and 22 cases underwent posterior long segment pedicle screw fixation through traditional open posterior approach combined with extensive laminectomy decompression(traditional-group).Perioperative information was recorded and analyzed respectively,such as the operation time,intraoperative blood loss,postoperative drainage,the Cobb angle,height of injured vertebral body,perioperative complications,VAS score and Frankel grade.Results The mean operation time,intraoperative blood loss,postoperative drainage,postoperative hospital stays,postoperative VAS score in Mini-group were significantly better than those in traditional-group.The Cobb angle,and height of injured vertebral body in two groups were significant improved in both groups after surgery compared to before,but there was no statistically significant difference between two groups(P all＜0.05).The Frankel grading of the two groups 3 months after surgery was no statistically significant difference between the groups(P＞0.05).Conclusion Posterior long segment pedicle screw fiixation through Wiltse paraspinal approach combined with minimal invasive laminectomy can reduce intraoperative blood loss,shorten operation time,and reduce paraspinal muscle damage.Meanwhile,it preserved rear stability structure to the maximum extent.
万方数据
维普
