Surgical outcomes of mini-open Wiltse approach and conventional open approach in patients with single-segment thoracolumbar fractures without neurologic injury

摘要

This study aimed to introduce a novel mini-open pedicle screw fixation technique via Wiltse approach,and compared it with the traditional posterior open method.A total of 72 cases of single-segment thoracolumbar fractures without neurologic injury underwent pedicle screw fixation via two different approaches.Among them,37 patients were treated using posterior open surgery,and 35 patients received mini-open operation via Wiltse approach.Crew placement accuracy rate,operative time,blood loss,postoperative drainage,postoperative hospitalization time,radiation exposure time,postoperative improvement in R value,Cobb's angle and visual analog scale(VAS)scores of the two methods were compared.There were no significant differences in the accuracy rate of pedicle screw placement,radiation exposure and postoperative R value and Cobb's angle improvement between the two groups.However,the mini-open method had obvious advantages over the conventional open method in operative time,blood loss,postoperative drainage,postoperative hospitalization time,and postoperative improvement in VAS.The mini-open pedicle screw technique could be applied in treatment of single-segment thoracolumbar fracture without neurologic injury and had advantages of less tissue trauma,short operative and rehabilitative time on the premise of guaranteed accuracy rate and no increased radiation exposure.