经Wiltse间隙入路治疗胸腰段无脊髓神经损伤骨折疗效观察

THE CLINICAL OUTCOMES OF WILTSE PARASPINAL INLET SURGERY FOR THORACOLUMBAR FRACTURES WITHOUT SPINAL CORD INJURY

目的通过比较研究经Wiltse间隙入路治疗胸腰段无脊髓神经损伤骨折与传统后正中棘突入路治疗的临床疗效。以制定科学的治疗方案。方法选取我科2011年7月-2014年4月间收治的64例胸腰段无脊髓神经损伤骨折患者为研究对象，随机分为观察组和对照组各32例，观察组采用经Wiltse间隙入路治疗进行治疗，对照组采用传统正中棘突入路进行治疗。治疗结束后，比较围手术期参数及视觉疼痛模拟评分（VAS）之间的差异。结果观察组术中出血量与术后48h引流量均显著少于对照组，手术时间与住院时间均显著短于对照组，术后VAS评分显著低于对照组，经t检验，其差异均具有统计学意义（P〈0．05）。结论与传统后正中棘突入路比较，Wiltse间隙入路具有手术时间短、术中损伤小、术后恢复好、住院时间短、疼痛程度低等优点，值得应用与推广。

Objective To compare the clinical outcomes between Wihse paraspinal inlet surgery and conven- tional posterior median spinous process inlet surgery for thoracolumbar fractures without spinal cord injury. Methods Sixty- four thoracolumbar fractures patients without spinal cord injury were randomly selected from 2011 July to 2014 April in our hospital, and were divided into an observation group （32 cases） and a contrast group （32 cases）. The observation group patients received Wiltse paraspinal inlet surgery; the contrast group patients received conven- tional posterior median spinous process inlet surgery. A comparison of the difference of the perioperative indexes and the records of visual analogue pain scale （VAS） was done after operation. Results Compared to the contrast group, there was significant difference of less blood loss, with less 48 hours drainage, shorter operation time, shorter hospi- talization time and lower VAS scores （p 〈 0.05） in observation group. Conclusion It is advisable to app｜y and ex- pand the Wiltse paraspinal inlet surgery for its advantages of shorter operation and hospitalization time, less injuries and pain, and better recovery, comparing from the conventional posterior median spinous process inlet surgery.