Wiltse椎旁入路治疗胸腰段压缩性骨折

目的探讨Wiltse椎旁入路治疗胸腰段压缩性骨折临床疗效。方法对59例胸腰段椎体压缩性骨折患者采用Wiltse椎旁入路固定治疗,记录术中出血量,对术前术后X线片进行测量。结果 59例均得到随访,时间1～18个月。按中医病症诊断疗效标准评价疗效:优38例,良16例,差5例,优良率为91.52%。术前椎体前缘高度14.38 mm±2.72 mm,Cobb角21.39°±2.64°;术后椎体前缘高度23.18 mm±2.96 mm,Cobb角16.27°±3.05°;差异均有统计学意义(P<0.01)。术中出血量130 ml±20 ml。VAS评分:术前为6.1分±1.3分,术后为0.5分±0.5分,差异有统计学意义(P<0.01)。结论 Wiltse椎旁入路应用于胸腰段压缩性骨折,创伤小、术后腰背疼痛轻。

Wiltse paraspinal approach to treat compression fractures of thoracolumbar spine

Objective To discuss the clinical efficacy of Wiltse paraspinal approach in treatment for thoracolumbar vertebral fracture.Methods 59 patients with thoracolumbar compression fracture were treated through Wiltse paraspinal approach with posterior internal fixation.Measurements included blood loss and preoperative and postoperative X-ray film.Results All cases were followed up for 18 months.The postoperative effect was excellent in 38 cases,good in 16 and poor in 5,and the excellent and good rate was 91.52%.The mean anterior vertebral height were(14.38±2.72) mm respectively before operation which increased to(23.18±2.96) mm respectively two years after operation(P<0.01).The kyphosis angle was 21.39°±2.64° before operation and decreased to 16.27°±3.05° two years after operation(P<0.01).Intraoperative blood loss was 130 ml±20 ml.The preoperative and postoperative VAS scores were with significant differences(P<0.01).Conclusions The Wiltse approach can avoid damaging important nerves or serious low back pain during the operation of thoracolumbar vertebral fracture and reduce complication.Operation plan formulated before operation and early active functional rehabilitation are the keys to obtain a good clinical result.