Comparison of Clinical Efficacy of Pedicle Screw Fixation by Different Approaches in the Treatment of Single-segment Thoracolumbar Fractures Without Neurologic Symptoms
Comparison of Clinical Efficacy of Pedicle Screw Fixation by Different Approaches in the Treatment of Single-segment Thoracolumbar Fractures Without Neurologic Symptoms
Objective To compare the clinical efficacy of pedicle screw fixation by paraspinal approach(Wiltse approach)and pedicle screw fixation by Sextant percutaneous approach(Sextant percutaneous approach)in the treatment of single-segment thoracolumbar fractures without neurologic symptoms.Methods 72 patients with single-segment thoracolum-bar fractures without neurologic symptoms,admitted to Anyang Yindu District Hospital of Traditional Chinese Medicine from March 2015 to October 2021,were enrolled as the research subjects,and divided into Wiltse group(n= 39)receiving pedicle screw fixation by paraspinal approach,and Sextant group(n = 33)receiving pedicle screw fixation by Sextant percutaneous approach.Surgery-related indicators,pain degree,and anterior vertebral body height ratio,Cobb angle and vertebral function were observed and compared between the two groups.Results Compared with the Sextant group,the intraoperative blood loss volume was much more(t=11.865,P＜0.001),the intraoperative fluoroscopy times were much less(t=19.892,P＜0.001),the operation time was significantly shorter(t=3.442,P＜0.001),and the length of stay was obviously longer(t=8.962,P＜0.001)in the Wiltse group.6 months after surgery,patients in the Wiltse group had significantly lower visual analogue scale(VAS)scores and Oswestry disability index(ODI)scores compared with the Sextant group(t=6.878 and 13.070,both P＜0.001),but there were no significant differences between the two groups in terms of anterior vertebral body height ratio and Cobb angle(t=1.658 and 1.628,P=0.102 and 0.108).Conclusion Wiltse approach and Sextant percutaneous approach can realize equivalent effect in correcting single-segment thoracolumbar fractures without neurologic symptoms.However,the Wiltse approach is superior in many aspects,including less intraopera-tive blood loss,shorter operation time,milder long-term pain after the surgery,and better recovery effect of vertebral functions,presenting much higher value of clinical application.
关键词
胸腰椎骨折/单节段/神经症状/经椎旁肌间隙椎弓根螺钉内固定/Sextant经皮椎弓根螺钉内固定
Key words
Thoracolumbar fracture/Single-segment/Neurological symptoms/Pedicle screw fixation by paraspinal approach/Pedicle screw fixation by Sextant percutaneous approach
维普
万方数据