Comparison of clinical effects in the treatment of thoracolumbar fractures with traditional posterior approach, paraspinal muscle approach and minimally invasive percutaneous approach

Abstract

Objective To compare the clinical outcomes of the traditional posterior approach, paraspinal muscle approach, and minimally invasive percutaneous approach for thoracolumbar fractures. Methods The clinical data of 95 patients with thoracolumbar fractures in Shanxi Aluminum Factory Staff Hospital from January 2015 to December 2017 were retrospectively analyzed. According to surgical approaches, they were divided into traditional posterior median group (traditional group, 31 cases), paraspinal muscle gap group (muscle gap group, 32 cases) and minimally invasive percutaneous pedicle screw fixation group (minimally invasive group, 32 cases). The perioperative conditions of the three groups were observed and compared, and the changes of kyphosis Cobb angle, vertebral height of the vertebral body and low back pain were observed before and 6 months after operation. Results The length of incision, operation time, intraoperative blood loss and hospital stay in the muscle interstitial group and the minimally invasive group were lower than those in the traditional group (P<0.05). The intraoperative blood loss in the minimally invasive group was lower than that in the muscle interstitial group (P<0.05). The kyphosis Cobb angle and the height of the anterior border of the vertebral body were better than those before operation (P<0.05). The visual analogue scale (VAS) scores of the three groups were lower than those before operation (P<0.05). The VAS scores of the muscle gap group and the minimally invasive group were lower than those of the traditional group (P<0.05). Conclusions Compared with the traditional posterior approach, the paravertebral muscle approach and minimally invasive percutaneous approach for the treatment of thoracolumbar fractures are more effective, and the minimally invasive percutaneous approach has a significant advantage in intraoperative blood loss. It is suitable for clinical promotion. Key words: Traditional posterior approach; Paraspinal muscle gap approach; Minimally invasive percutaneous approach; Thoracolumbar fracture