Abstract：Objective To compare the efficacy of percutaneous and Wiltse approach pedicle screw fixation with injured vertebrae in the treatment of single segmental，non-nerve injury and thoracolumbar injury assification and severity(TLICS)-4 thoracolumbar fractures.Methods A retrospective study was conducted on the patients with thoracolumbar fracture treated in our hospital from January 2016 to January 2019，of which 64 cases met the study criteria.The patients were divided into two groups using category matching：percutaneous pedicle screw group (percutaneous group) and Wiltse pedicle screw group (Wiltse group).There were 32 cases in percutaneous group，including 19 males and 13 females，aged from 21 to 55 years old，with an average of (36.42 ±6.31)years.The kyphosis Cobb angle before and after operation was 18°~35°，with an average of (24.72±4.64)°.There were 32 patients in the Wiltse approach group，including 21 males and 11 females，aged from 19 to 52 years old，with an average age of (38.52±6.62) years.The preoperative and postoperative kyphosis Cobb angle ranged from 20°~36 °，with an average of (25.72±5.14)°.All the patients in the study were fixed with 6 pedicle screws through the injured vertebrae.The operation time，intraoperative blood loss，incision size，hospitalization days，intraoperative fluoroscopy times，Visual analogue scale(VAS) of 1 day before operation，1 day，3 days，7 days and 14 days after operation，postoperative and postoperative kyphosis Cobb angle were recorded and compared between the two groups.Oswestry disability index (ODI) score was followed up 1 year after operation.All patients were followed up for 12~18 months，with an average of (15.62±3.76)months.Results During the follow-up period，no complications such as iatrogenic vascular and nerve injury，incision infection and failure of internal fixation occurred in both groups.There was no significant difference in operation time，intraoperative blood loss，incision size，hospital stay and Cobb angle before and after operation between the two groups(P＞0.05).There was no significant difference in the scores of 1 day before operation and 1 day，3 days，7 days and 14 days VAS after operation (P＞0.05).The number of intraoperative fluoroscopy in the percutaneous group was significantly more than that in the Wiltse group (P＜0.05).The postoperative Cobb angle of the two groups was significantly lower than that before operation，and there were significant differences between groups and within groups (P＜0.05).There was no significant difference in ODI score between the two groups after 1 year follow-up (P＞0.05).Conclusion Percutaneous and Wiltse approach pedicle screw fixation has the same short-term effect in the treatment of thoracolumbar fracture with single segment，no nerve injury and TLICS 4 score，but the Wiltse approach group has less fluoroscopy times and better postoperative Cobb angle recovery.Whether there is a long-term difference requires longer follow-up.
翁友林，李祖涛，蔡昱，孙俊刚，徐江波. 经皮与Wiltse入路椎弓根钉治疗TLICS 4分胸腰段骨折的疗效对比[J]. 实用骨科杂志, 2021, 27(12): 1057-1063.
Weng Youlin，Li Zutao，Cai Yu，et al. Comparison of Percutaneous Versus Wiltse Approach with Pedicle Screws in the Treatment of Thoracolumbar Fractures with TLICS 4. sygkzz, 2021, 27(12): 1057-1063.
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