Study on the Effect of Different Approaches of Vertebral Arch Screw Internal Fixation in the Treatment of Thoracolumbar Compression Fractures

Zhao Shibo; Wang Linjie; Fan Cunshuai

doi:10.3969/j.issn.1004-5775.2025.10.014

Abstract：Objective:To observe the clinical application effect of different approaches of pedicle screw internal fixation on thoracolumbar compression fractures.Methods:103 patients with compression fractures of the thoracolumbar spine were selected.Based on the severity of the condition and different surgical indications.53 patients who met the criteria for posterior lumbar intermuscular space(Wiltse)surgery were included in the Wiltse group,while the remaining 50 patients who met the criteria for traditional percutaneous approach were included in the control group.All patients were followed up for six months after surgery.The treatment,rehabilitation,pain,and recovery of vertebral structure and function between two groups of patients were compared.Results:Operation time,hospital stay,bed rest time and fracture healing time in Wiltse group were higher than those in conventional group,with statistically significant difference(t=2.188,3.780,2.157,3.052;P＜0.05).1 day,3 and 5 days after surgery,VAS scores in Wiltse group were lower than those in conventional group,with statistically significant difference(t=2.707,2.276,5.758;P＜0.05).2 and 4 weeks after surgery,the Cobb Angle in Wiltse group was lower than that in conventional group,and the vertebral anterior margin height was higher than that in conventional group,with statistically significant difference(t=2.724,3.111,2.849,2.839;P＜0.05).The ODI score in Wiltse group was lower than that in conventional group,and the JOA score was higher than that in conventional group,with statistically significant difference(t=2.970,2.625,3.371,3.000;P＜0.05).Conclusion:The implementation of pedicle screw internal fixation through the Wiltse approach can accelerate the recovery process,alleviate postoperative pain of patients with thoracolumbar compression fractures,and promote the recovery of vertebral structure and function.