Comprasion Of Clinical Effect Of Transpedicle Screw Fixation Combine Lordorizing Screw Fixation Via Percutaneous Way And Wiltse Paraspinal Approach To Treat Thoracolumbar Spine Fracture

Objective To demonstrate the clinical effects of transpedicle screw fixation combine lordorizing screw fixation via percutaneous way and Wiltse paraspinal approach to treat thoracolumbar spine fracture without neurotrosis.Methods A retrospective analysis was conducted of 52 patients with thoracolumbar spine fracture without neurotrosis who had undergone transpedicle screw fixation combine lordorizing screw fixation from January 2015 to January 2018.The patients were divided into Group A(percutaneous way,n=27)and Group B(Wiltse paraspinal approach,n=25).During the follow-up period of 12 months,the outcomes from both groups included bleeding volume,operation time,the postoperative use of analgesic drug,postoperative grounding time and hospital stay,visual analog scores(VAS)of low back pain at different time points before and after surgery,the anterior height of vertebra and Cobb angle before and 12 months after surgery.Results No complications occurred in either group.Operation time in Group A were longer than in Group B(P<0.05).There were no significantly differences between the two groups in blood loss(P>0.05).The patients who using analgesic post-operation in Group A were significantly more than in Group B(P<0.001).Time for ambulation in Group A were longer than in Group B(P<0.05),but none difference in length of hospital stay(P>0.05).VAS scores for waist pain post-operation were significantly lower in both groups than VAS scores pre-operation(P<0.001).There was no significant difference between group B and group A before and 12 months after surgery(P>0.05),but VAS scores at 3 days months post-operation in Group B were lower than in Group A(P<0.05).In both groups,the anterior height of the injured vertebra is significantly restored 12 months after surgery compared with that before operation,the difference was statistically significant(P<0.001).But there was no significant difference between both groups(P>0.05).The Cobb angles of the sagittal plane of the injured vertebra in both groups were significantly improved 12 months postoperatively when compared with those before the grounding postoperatively,the difference was statistically significant(P<0.001).However,there was no significant difference between both groups(P>0.05).Conclusion Transpedicle screw fixation combine lordorizing screw fixation via percutaneous way and Wiltse paraspinal approach all have the favorable and similar clinical effects to improve fracture deformity and long-term pian,but the percutaneous way can result in longer operation time and time for ambulation,more short-term pain,and have no more advantage than Wiltse paraspinal approach.