经Wiltse入路峡部植骨跨运动节段内固定治疗腰椎峡部裂的临床效果

目的观察经Wiltse入路峡部植骨跨运动节段内固定治疗腰椎峡部裂的临床效果。方法以我院2017年3月至2019年11月收治的82例腰椎峡部裂患者为研究对象,以随机数字法将其分成对照组和试验组,各41例。两组患者均拟行峡部植骨跨运动节段内固定治疗,其中对照组患者实施常规入路,而试验组患者实施经Wiltse入路。比较两组患者的围手术期相关指标(切口长度、术中出血量、手术时间、术后引流量、住院时间)及术前、术后7 d的视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)评分。结果试验组的切口长度、手术时间、住院时间均短于对照组,术中出血量与术后引流量均少于对照组(P<0.05)。术后7 d,两组患者的VAS、ODI评分较术前明显下降,且试验组低于对照组(P<0.05)。结论采取经Wiltse入路峡部植骨跨运动节段内固定治疗腰椎峡部裂患者,可明显缩短患者的切口长度、手术时间、住院时间,减少术中出血量和术后引流量,减轻术后7 d的疼痛与功能障碍,效果理想。

Clinical effect of isthmic bone grafting and transmotor segmental fixation via Wiltse approach in the treatment of lumbar spondylolysis

Objective To observe the clinical effect of isthmic bone grafting and transmotor segmental fixation via Wiltse approach in the treatment of lumbar spondylolysis.Methods A total of 82 cases of lumbar spondylolysis patients admitted in our hospital from March 2017 to November 2019 were selected as the research objects.The patients were divided into control group and experimental group by random number method,with 41 cases in each group.The patients in both groups were planned to receive isthmic bone grafting and transmotor segmental internal fixation.The control group was given conventional approach,while the experimental group was treated by Wiltse approach.The perioperative related indexes(incision length,intraoperative blood loss volume,operation time,postoperative drainage volume,hospitalization time)and the scores of visual analogue scale(VAS)and oswestry disability index(ODI)before and 7 days after operation were compared between the two groups.Results The incision length,operation time and hospitalization time of the experimental group were shorter than those of the control group,and the intraoperative blood loss volume and postoperative drainage volume were less than those of the control group(P<0.05).At 7 d after operation,VAS and ODI scores of the two groups were significantly lower than those before operation,and those in the experimental group were lower than the control group(P<0.05).Conclusion The isthmic bone grafting and transmotor segmental fixation via Wiltse approach in the treatment of lumbar spondylolysis patients can significantly shorten the incision length,operation time and hospitalization time of the patients,reduce intraoperative blood loss volume and postoperative drainage volume,and relieve the pain and dysfunction at 7 d after the operation,with ideal results.