Comparison of the Wiltse Approach and Percutaneous Pedicle Screw Fixation for the Treatment of Neurologically Intact Thoracolumbar Fractures

Abstract

Purpose: To compare the curative effect of two minimally invasive techniques for neurologically intact thoracolumbar fractures. Methods: 37 patients with type A fractures without neurological deficits were selected and divided into two groups. Among them, 18 patients received percutaneous pedicle screw fixation (PPSF group), and 19 patients were treated using a mini-open Wiltse approach with pedicle screw fixation (WPSF group). The clinical outcomes, surgery-related results, and radiological findings were compared between the two groups. Results: The length of incision, intraoperative blood loss, post-operative hospitalization time, satisfaction, visual analog score (VAS), and Cobb’s angle between the two groups showed no significant differences (P > 0.05). However, the operation time and the number of intraoperative fluoroscopy of the WPSF group were significantly lower than those of the PPSF group (P < 0.05). Conclusion: Both minimally invasive techniques are effective for neurologically intact thoracolumbar fractures. Nevertheless, the mini-open Wiltse approach has lower radiation exposure and a shorter learning curve compared with PPSF. A larger sample, multi-center randomized controlled study is necessary to prove the clinical effectiveness of the Wiltse approach.