The Clinical Effect of Manual Reduction Combined with Internal Fixation Through Wiltse Paraspinal Approach in the Treatment of Thoracolumbar Fracture

Abstract

Objective: To evaluate the clinical outcome of manual reduction combined with pedicle fixation through Wiltse paraspinal approach (WPA) in the treatment of thoracolumbar fractures.Methods: From May 2017 to May 2019, 48 thoracolumbar fractures patients without neurological symptoms were enrolled in this study. Forty-eight patients were randomly divided into two groups based on the different surgical treatment. Group 1 was manual reduction combined with pedicle screw fixation through Wiltse paraspinal approach treatment group. Group 2 was pedicle screw fixation through traditional posterior approach treatment group. The operation time (OT), intraoperative blood loss (BL), postoperative drainage (PD), time of brace (TB) and the cobb angle recovery of the injured kyphosis in the prone position were obtained and compared between the two groups, respectively. Comparison of cobb angle changes, serum creatine kinase (CK) level, pain visual analogue score (VAS), Oswestry disability index (ODI), and multifidus cross-sectional (MCS) area changes were achieved between the two groups, respectively.Results: Forty-eight patients were enrolled in this study and each group had 24 patients. There was no significant difference between the two groups in patient's age, height, weight, and body mass index (BMI). There were 20 males and four females in group 1. The mean age, height, weight, and BMI of patients were 61.

Comparing the Wiltse approach and classical approach of pedicle screw and hook internal fixation system for direct repair of lumbar spondylolysis in young patients: A case-control study

“…Wiltse technique has become an increasingly popular minimally invasive approach in thoracolumbar surgery, [ 11 , 23 ] and has been reported to have the advantages of shorter operation time and hospital stay, less bleeding, lower cost, and lower incidence of complications. [ 24 ] In this study, intraoperative blood loss, postoperative drainage volume, and hospital stay of the Wiltse approach were significantly lower than those of classical group, indicating that the Wiltse technique is a relatively less invasive isthmus repair approach, which is consistent with other reports.…”

Manual Reduction, Subpedicle Approach, and Body Cages to Treat Burst Fracture

“…The frame use is limited in non-operative acute fracture and cephalic traction force through cervical spine is poor in force quantity and direction adjustment. In 2018, Carlo et al [29] reported a 3-member manual reduction for acute burst fracture as a technical note; in 2021, Li et al [30] confirmed the effect of a 3-member manual reduction in acute spine fractures. However, a 3-member manual reduction is weak to correct chronic deformity following spine fracture because it cannot change the patient posture according to the deformity.…”

Clinical outcomes of Short Rod Technique in transforaminal lumbar interbody fusion surgery through Wiltse approach: A case series report

“…He later modi ed his approach so that it could be applied in other lumbar diseases 10 . Different with traditional spine surgery which needs dissection of bilateral muscles, this approach does not need to intraoperatively strip the paraspinal muscles, and many advantages of this approach have been fveri ed, such as less trauma, less intraoperative bleeding, and quicker recovery 11 . Therefore, Wiltse approach has been widely used in the surgical treatment of spine surgeries, especially for elder patients who could not suffer the variety of complications including deep vein thrombosis, hypostatic pneumonia, and pressure sores.…”