Curative effect of the Wiltse approach combined with injured vertebrae fixation in the treatment of thoracolumbar fractures

Objective:To compare the curative effects between Wiltse approach and traditional approach combined with injured vertebrae fixation in the treatment of thoracolumbar fractures.Methods:A total of 45 patients with thoracolumbar fractures were divided into the observation group(n=22) and control group(n=23).The control group was treated with the traditional posterior midline approach combined with injured vertebrae fixation,and the observation group was treated with the Wiltse approach combined with injured vertebrae fixation.The operation time,intraoperative bleeding,anterior height of the vertebral body before and after operation,kyphose Cobbs angle and postoperative internal fixation,and loss of restoration in two groups were observed.Results:The operations in two groups were successful,and the incisions of all cases were primary healing.No nerve injury,internal fixation bent,loosing,rupture and lumber vertebra losing function were found.All cases were followed up for 12 to 18 months,and achieved the clinical goal of osseous healing.The difference of the operation time between two groups was not statistically significant(P>0.05).The intraoperative bleeding and postoperative drainage volume in observation group were significantly less than those in control group(P<0.01).After 2 weeks and 1 year of operation,the anterior height of the injury vertebral body in two groups was ignificantly higher than those of before operation(P<0.01),and the Cobbs angle in two groups was significantly lower than those of before operation(P<0.01).The differences of anterior height of the injury vertebral body and Cobbs angle before operation,and after 2 weeks and 1 year of operation between two groups were not statistically significant(P>0.05).Conclusions:The Wiltse approach combined with vertebrae fixation in the treatment of thoracolumbar fractures can effectively protect the spine posterior muscle,reduce the incidence of lumber vertebra losing function,and is minimally invasive and less bleeding.The injured vertebrae fixation can help to recover the vertebral body height and decrease the occurrence of internal fixation system losing function.