改良Wiltse入路微创小切口手术在单节段椎体骨折患者中的疗效研究

Study on the Effect of Minimally Invasive Minimal Incision Surgery with Modified Wiltse Approach in Patients with Single-segment Vertebral Fractures

目的:探讨改良Wiltse入路微创小切口手术在单节段椎体骨折患者中的疗效。方法:选取2020年3月-2021年7月于内蒙古科技大学包头医学院第一附属医院接受手术治疗的218例单节段胸腰椎体骨折患者为研究对象,按照手术方式分为对照组106例与观察组112例。对照组应用传统Wiltse入路手术进行治疗,观察组应用改良Wiltse入路微创小切口手术。记录并比较两组手术情况、病椎高度丢失率、Cobb角矫正度、疼痛评分、功能障碍评分以及疗效情况。结果:观察组手术时间、住院天数、切口长度以及骨折愈合时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。观察组病椎高度丢失率、Cobb角矫正度、疼痛评分以及功能障碍评分均低于对照组,差异均有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论:相对于传统Wiltse入路手术,改良Wiltse入路微创小切口手术能够明显缓解患者的疼痛程度,减少术中出血量,缩短住院时间,具有良好的治疗效果,适合临床推广。

Objective:To explore the effect of minimally invasive minimal incision surgery with modified Wiltse approach in patients with single-segment vertebral fractures.Method:A total of 218 patients with single-segment thoracolumbar fractures who received surgical treatment in the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from March 2020 to July 2021 were selected as the research objects,they were divided into control group(106 cases)and observation group(112 cases)according to operation methods.The control group was treated with traditional Wiltse approach,and the observation group was treated with minimally invasive minimal incision surgery with modified Wiltse approach.The surgical conditions,height loss rate of diseased vertebrae,Cobb angle correction,pain score,dysfunction score and curative effect were recorded and compared between the two groups.Result:The operation time,hospital stay,incision length and fracture healing time in the observation group were shorter than those in the control group,and intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).The height loss rate of diseased vertebrae,Cobb angle correction,pain score and dysfunction score in the observation group were significantly lower than those in the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Compared with the traditional Wiltse approach,minimally invasive minimal incision surgery with modified Wiltse approach can significantly alleviate the pain of patients,reduce the amount of intraoperative bleeding and shorten the length of hospital stay,it has good therapeutic effect and is suitable for clinical promotion.