Comparative Study Of Thoracolumbar Fracture Without Neurological Deficit By Wiltse Approach And Minimally Invasive Percutanrous Approach

Objective To compare the therapeutic effect of posterior paraspinalapproach(Wiltse approach) fracture restoration pedicle screw fixation andminimally invasive percutaneous pedicle screw fixation(PPSF) for thetreatment of thoracolumbar fracture without neurological deficit. MethodsA total of37patients with thoracolumbar instability fracture underwentWiltse approach fracture restoration pedicle screw fixation(22cases) andminimally invasive PPSF(15cases) between January2008and January2011.All the patients were single-level instability fracture without neurologicaldeficit. Results There was no significant differences between the two groupsin terms of the incision length，blood loss，postoperative drainage，lengthof stay and activities time out of bed(P>0.05). There was significantdifferences between the two groups in terms of operative time、fluoroscopytimes，cost of surgery (P <0.05). The median follow-up times were18months(range6to36). There was significant differences in each group withrespect to visual analogue scale(VAS) and oswestry disability index(ODI) when compared the preoperative value with the final follow-up value (P<0.05). There was no significant differences between the two groups withrespect to visual analogue scale(VAS) and oswestry disability index(ODI)when compared the preoperative value with the final follow-up value (P>0.05).There was significant differences in each group in terms of anteriorvertebral height，posterior vertebral height，sagittal Cobb`s angle andvertebral body angle when compared the preoperative value with the12months postoperative value(P <0.05).There was no significant differencesbetween the two groups in terms of anterior vertebral height，posteriorvertebral height，sagittal Cobb`s angle and vertebral body angle whencompared the preoperative value with the12months postoperative value(P>0.05).The improvement of the index have no significant difference betweenthe two groups(P>0.05). Conclusion Both of the two operative proceduresare the ideal methods for the treatment of instability thoracolumbar fracturewithout neurological deficit. paraspinal approach fracture restoration pediclescrew fixation is a simple, safe and effective operative procedure with lowprice in the treatment of thoracolumbar fracture.