Wiltse入路与传统后正中入路治疗无神经表现的腰椎骨折

Wiltse Approach and Posterior Midline Approach for the Treatment of Vertebral Fractures without Neurological Symptom

目的：探讨Wiltse入路与传统后正中入路治疗无神经表现的腰椎骨折的临床疗效。方法：选择2013年8月~2015年8月符合标准的腰椎骨折患者68例,随机分为观察组和对照组各34例,观察组采用Wiltse入路,对照组采用传统后正中入路,行钉棒撑开复位内固定,观察手术效果。68例患者均获得随访,平均随访18个月。结果：观察组患者手术时间、术中出血量、术后引流量及术后（1周）视觉模拟评分（VAS评分）与对照组比较差异均有统计学意义（P〈0.05）,两组术后椎体高度矫正率及Cobb’s角矫正率差异无统计学意义（P〉0.05）。结论：在腰椎手术中,相比传统后正中入路,Wiltse入路治疗无神经表现的腰椎骨折更安全有效,有创伤小、出血少及术后恢复快等优点。

Objective： To evaluate the clinical efficacy o f Wiltse approach and posterior midline approach for the treatment of vertebral fractures without neurological symptom. Methods： From August 2013 to August 2015, 68 cases were divided into observation group （34 cases） and control group （34 cases）, the observation group were treated with Wiltse approach, the control group were treated with posterior midline approach. All patients were received nail fixation rod distraction and the operation efficacy was observed. 68 Patients were followed up for a mean of 18 months. Results： There were no significant difference in postoperative Cobb angle correction rate and vertebral collapse rate （P〉0.05） between groups; While in the operating time, blood loss, postoperative drainage and VAS score one week after operation in the observation group were better than those in the control group （P〈0.05）. Conclusion： The Wiltse approach is better than the posterior midline approach for lumbar spine operation, which develops less injury and less bleeding and faster postoperative recovery, etc.