经Wiltse入路治疗胸椎骨折的围手术期临床观察

Perioperative clinical efficacy of the treatment of thoracic vertebrae fracture by Wiltse paraspinal approach

目的探讨经Wiltse肌间隙入路治疗胸腰椎骨折的围手术期临床疗效。方法对无神经症状胸腰椎骨折经后路置入椎弓根钉内固定治疗67例,采用Wiltse肌间隙入路32例(A组),传统后正中入路35例(B组),分别记录围手术期两组手术时间、术中出血量、术后引流量、术后下床活动时间、胸腰椎疼痛VAS评分,比较两组的围手术期治疗效果。结果末次随访中,A组手术时间、术中出血量、术后引流量、术后下床活动时间、胸腰椎疼痛VAS评分,均少于B组(P<0.05)。结论经Wiltse肌间隙入路椎弓根钉固定具有创伤小、手术时间短、出血量少、恢复快等优点,是值得推广的一种手术入路。

Objective To investigate the perioperative clinical efficacy for thoracolumbar fractures by Wiltse paraspinal approach.Methods 67 cases of thoracolumbar fractures without neurological symptoms were treated with posterior pedicle screw fixation,32 cases were treated with Wiltse intermuscular approach(group A),35 cases were treated with traditional posterior median approach(group B).Perioperativetime,intraoperative blood loss,postoperative drainage,the leaving bed time and postoperative pain VAS score of the two groups were recorded,respectively,and the perioperative therapeutic effect of the two groups was compared.Results At the last follow-up,operative time,intraoperative blood loss,postoperative drainage,the leaving bed timeand postoperative pain VAS scorein group A was better than those in group B(P<0.05).Conclusion The Wiltse paraspinal approach with pedicle screw fixation has the advantages of simple approach,less intraoperative injuries,less operative time,low blood loss and faster recovery,which is worth promoting as a surgical approach.