Two different surgery approaches for treatment of thoracolumbar fracture

To evaluate the safety and effectiveness of pedicle screw fixation for treatment of thoracolumbar fracture via Wiltse paraspinal approach.

From June 2009 to June 2012, we enrolled into our study 53 cases of thoracolumbar fractures (single segment compressive or burst fractures) without neurologic injury, among whom 28 were treated by mini-open operation via Wiltse approach (group A) and 25 by conventional posterior open surgery (group B). We recorded and compared the intraoperative and postoperative performance between the two groups.

There was no serious complications occurring during our study, such as infection, blood vessel injury, spinal cord or nerve root injury. We did not find any statistically difference between the two groups in corrected rate of Cobb's angle or vertebral body height (P>0.05). However, the mini-open method had apparent advantages over the conventional open method in operative time, intraoperative blood loss, postoperative drainage, and postoperative improvement on visual analog scale (VAS) scores at 3 days, 1 month, and 6 months after operation (P<0.05). After 9-24-month follow-up, the number of patients with low back pain in group A was less than that in group B.

In the premise of strict controlling surgery indications, pedicle screw fixation via Wiltse paraspinal approach has the advantages of simple operation and less trauma in treatment of single-segment thoracolumbar fracture without neurologic injury.