Wiltse 入路与后正中入路在胸腰椎骨折内固定取出术中应用的疗效比较

目的比较Wiltse入路与传统后正中入路行胸腰椎骨折内固定取出术的疗效。方法将52例胸腰椎骨折术后需行内固定取出的患者按数字随机表法分为2组，分别采用Wiltse入路与传统后正中入路进行手术治疗，比较2组手术时间、术中出血量、术后引流量、术后疼痛视觉模拟评分（VAS评分）的差异。结果2组患者均顺利取出内植物，无椎弓根螺钉断裂发生。Wiltse入路组患者手术时间（35．80±2．833）min、术中出血量（17．20±1．568）mL、术后引流量（20．33±1．988）mL及术后VAS评分（1．90±0．738）分，均明显低于传统后正中人路组的（55．33±2．769）min、（45．40±2．473）mL、（50．20±4．799）mL、（3．00±0．667）分（P〈0．05），Wiltse人路组疗效优于传统后正中入路组。结论Wihse人路行胸腰椎骨折内固定取出术，在手术时间、术中出血量、术后引流量及术后VAS评分方面均明显优于传统后正中入路，手术创伤小、出血少、疼痛轻、恢复快，可作为胸腰椎骨折内固定取出的良好人路选择。

Comparison of effects of fixation removal in thoracolumbar fracture through the Wiltse approach and the posterior midline approach

Objective To compare the therapeutic effects of fixation removal of thoracolumbar fracture by the Wiltse approach and the posterior midline approach. Methods 52 patients who needed the fixation removal of the thoracolumbar fracture were randomly divided into two groups： the posterior midline approach and the Wihse approach. The operation time, the bleeding volumes during the operation, the drainage volumes and the VAS scores were compared between the two groups. Results No pedicle screw fracture was founded in all the patients. The group of the Wiltse approach had less operation time,less bleeding volumes, less drainage volumes and less VAS scores com- pared with the group of the posterior midline approach. Conclusion The Wiltse approach has minimal invasive, less bleeding volumes, lower pain and more rapidly recovery, and is considered a better choice in fixation removal of thoraeolumbar fracture.