Comparative Study Of Percutaneous And Wiltse Approach Pedicle Screw Fixation In The Treatment Of Single Level Thoracolumbar Fracture

PurposeTo evaluate the efficacy of percutaneous pedicle screw fixation and Wiltse approach pedicle screw fixation in the treatment of single level thoracolumbar fracture,statistical analysis of the advantages and disadvantages of two kinds of operation method,study percutaneous pedicle screw internal fixation technique for thoracic lumbar vertebral compression fractures of the clinical application value.MethodsA stady of 48 patients with single levelthoracolumbal fractures between August 2014 and October 2019 were analyzed.Patients were treated with percutaneous pedicle screw fixation（25 cases,percutaneous group）and Wiltse approach pedicle screw fixation（23cases,Wiltse group）.The length of surgical incision,operationtime,intraoperative blood lossand hospital stay of patients in the two groups were collected and recorded by clinical scale measurement,referring to records of doctors’ office system and anesthesiologist’s office system.Clinical medical records,outpatient review were also collected.Preoperative and postoperative pain visual analog scale（VAS）score,preoperative and postoperative the ratio of anterior vertebral height of affected vertebral body,and Cobb’s angle of kyphosis were collected.The operative time,surgical blood loss,length of hospital stay,incision length,Visual analogue scores of before and after surgery in 2 groups were retrospectively analyzed,and ratio of anterior vertebral height of affected vertebral body,and Cobb’s angle of kyphosis were collected were compared preoperative and same time point postoperatively.ResultsAll patients were discharged successfully and followed up for more than 12 months.Compared with the Wiltse group,the incision length,operation time,surgical blood loss and hospitalization days in the percutaneous group were lower than those in the Wiltse group,with statistically significant differences（P <0.05）.VAS score of the two groups decreased significantly compared with that before surgery,and the difference was statistically significant（P<0.05）.VAS score of the percutaneous group one day and one week after surgery was lower than that of the Wiltse group,and the difference was statistically significant（P<0.05）.VAS score of the two groups 1 month after surgery and the last follow-up showed no statistical difference（P > 0.05）.the height of the injured vertebra and the Cobb’s angle of kyphosi between the two groups were significantly improved after surgery compared with that before surgery,and the differences were statistically significant（P<0.05）,while there were no statistically significant differences in ratio of anterior vertebral height of affected vertebral body,and Cobb’s angle of kyphosis between the two groups same time point postoperatively（P>0.05）.ConclusionFor the treatment of single segment A thoracic and lumbar vertebral fracture,both groups of surgery has been the effective recovery of the vertebral height and posterior deformity,percutaneous pedicle screw fixation compared with Wiltse pedicle screw fixation,with small surgical trauma,postoperative recovery,more conducive to patient recovery,and postoperative short-term improvement of patients with back pain effect.