Comparison Between Wiltse Approach And Minimally Invasive Percutaneous Approach In Treating Thoracolumbar Fractures On Degree Of Paravertebral Muscle Injury And Short-term Efficacy

Objective:In this study,we compared the degree of paravertebral muscle injury and the short-term efficacy of the vertebral pedicle screw fixation with the Wiltse approach(transforator muscle space approach)and minimally invasive percutaneous approach in the treatment of simple nerve-free thoracolumbar fracture Difference.Method:60 patients in our hospital who selected a single-segment thoracolumbar spine fracture without nerve injury from January 2018 to July 2019 and selected surgical treatment were randomly divided into two groups according to the random number table method,a group of 32 patients The surgical method of the wildt approach was adopted(experimental group),and the 28 patients in the other group adopted the minimally invasive percutaneous approach(control group).Observe the operation time,intraoperative blood loss,and preoperative preparation time of the two groups of patients;use EMG,changes in paravertebral muscle area before and after surgery,and changes in creatine kinase before and after surgery to study the different surgical methods for paravertebral muscles At the same time,through the wildt approach and minimally invasive percutaneous approach in patients with preoperative and postoperative vertebral anterior margin height ratio,Cobb angle changes to compare the fracture treatment of patients.Results:All the experimental patients completed the operation smoothly and safely,no postoperative complications occurred,and there was no significant difference in serum creatine kinase content before surgery,and there was no statistical significance(P>0.05).The difference before and after the treatment was statistically significant.The difference in creatine kinase between the two groups after operation was statistically significant(P<0.05.The difference between the needle electromyography before and after operation was significant.There was a significant difference between the two groups of patients after the multifidus muscle area change was statistically significant(P<0.05.The difference in intraoperative drainage,postoperative drainage and operation time between the two groups was statistically significant(P<0.05).The comparison of the Cobb angle and the height of the anterior edge of the injured vertebrae between the two groups of patients before and after operation was compared.There was no significant difference in the ratio of Cobb angle and anterior edge height of the injured vertebrae before and after operation(P>0.05).Conclusion:Thoracic and lumbar fractures with no nerve injury were treated with wilted and minimally invasive percutaneous pedicle screw surgery for fractures.The effect is equivalent.Both approaches have damage to the paravertebral muscles in the early postoperative period.