经Wiltse入路结合伤椎置钉内固定治疗老年A3型胸腰段骨折的临床研究

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Abstract Objective To explore the clinical effect of Wiltse approach combined with internal fixation of the injured vertebra with screws in treatment of type A3 thoracolumbar fracture in the elderly.Methods A total of 78 elderly patients with type A3 thoracolumbar fractures admitted to Quannan People′s Hospital and Ganzhou People′s Hospital of Jiangxi Province from June 2018 to June 2019 were selected as the research objects,and they were divided into control group(39 cases)and study group(39 cases)according to the random number table method.The control group was treated with internal fixation of vertebral screw through the traditional surgical approach,and the study group was treated with internal fixation of vertebral screw through the Wiltse approach.The operative time,intraoperative hemorrhage,postoperative drainage and postoperative complications were compared between the two groups.The pain score(visual analogue scale [VAS]),Oswestry disability index(ODI)and kyphosis Cobb angle were compared between the two groups at before operation,1 month after operation,6 months after operation and 12 months after operation.Results The operation time of the study group was shorter than that of the control group,intraoperative hemorrhage and postoperative drainage were less than those in the control group,the differences were statistically significant(P＜0.05).There were no significant differences in VAS scores,ODI scores and kyphosis Cobb angle between the two groups at before operation(P＞0.05),but the VAS scores,ODI scores and kyphosis Cobb angle of the study group were lower than those of the control group at 1 month,6 months and 12 months after operation,the differences were statistically significant(P ＜0.05).There was no significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion Wiltse approach combined with internal fixation of the injured vertebra with screws is effective in the treatment of type A3 thoracolumbar fractures in the elderly,with less intraoperative hemorrhage,less postoperative pain and faster postoperative recovery.

Key words： Wiltse approach Traditional post median approach Internal fixation Thoracolumbar fracture

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