EMG Evaluate The Effects Of Function Of Paravertebral Muscle Between Witlse Approach And Conventional Approach With Vertebral Pedicle Screw System In Treatment Of The Thracolumbar Vertebral Fracture

Objective:By comparison of the difference of the paraspinal muscle EMG between theWiltse approach with the traditional approach pedicle fixation treatment without nerve injurythoracolumbar fractures evaluate the difference of influence of paraspinal muscle functionafter internal fixation removed.Methods:The clinic and telephone follow-up patients which had been removed interalfixation over12months in69cases, in which37cases had undergone Wiltse approachpedicle screw fixation, consisting of minimally invasive surgery group, and32cases hadundergone traditional pedicle screw fixation, consisting of a total of of conventional surgerygroup. Last follow-up observation of paraspinal muscle EMG changes and follow-up SF-36scores and Oswestry Disabilty Index score; while the first two groups were comparedoperative time, blood loss, postoperative drainage, postoperative bed time, hospitalizationtime. The use of statistical methods to follow-up the results of statistical indicators oftreatment, P <0.05was considered statistically significant.Results:Last Follow-up in patients with SF-36scores and ODI scores weresignificantly different between the minimally invasive group and the traditional group, thedifference was statistically significant (P <0.05); Last follow-up minimally invasive groupand the traditional group of EMG in resting state,28cases(87.5%%,28/32) of the traditionalgroup are simultaneously two or more fibrillation potentials and positive sharp waves, only three cases (near8.1%,3/37) of invasive group two or more simultaneously fibrillationpotentials and positive sharp waves, significant differences between the two groups; underlight contraction,28cases (87.5%,28/32) of the traditional group motor unit potentialduration and amplitude decreases with patients able to tolerate increases were mixed checksappear and there is more with increasing wave phenomenon,tree cases (near5.4%,2/37) ofminimally invasive group appeared no motor unit potential duration and amplitude decreaseor increase, there are significant differences between the groups; maximum force status,28cases(87.5%,28/32) of the traditional group were examined potential emergence of a peak in1mv to2mv interference phase and mixed-phase alternating, while there is greater than10mv or less than the peak potential1mv pure phase, two cases (near5.4%,2/37) ofminimally invasive group raised no interference phase and mixed phase occurs, significantdifferences between the two groups. Bleeding after ambulation time comparison groups andthe differences were statistically significant (P <0.05), minimally invasive group were lowerthan the traditional group; mean operative time, length of hospital stay was no significantdifference in comparison (P>0.05).Conclusion After Wiltse approach to avoid stripping paraspinal muscles, reducesblood loss, reduced paraspinal soft tissue damage and protect the multifidus muscleinnervation, retains the key spine stabilization system, significantly reduce the incidence ofsurgical trauma caused by degeneration of the paraspinal muscles.