A Comparative Study of Effects on Wiltse Approach Pedicle Screw-Rod Fixation and Posterior Midline Small Incision Non-fusion Surgery in Patients with Thoracolumbar Spinal Fractures
ZHU Honghe
LI Yang
ZHU Mengkun
SONG Ya
GUO Xiaowei
SUN Yibao
MEI Wei
Abstract：Objective To compare the effects of posterior pedicle screw rod reduction and fixation via the paraspinal muscle space(Wiltse)approach and posterior midline small incision non-fusion surgery in patients with thoracolumbar spine fracture(TSF),as well as their impact on surgery-related indicators and incidence of complication.Methods The data of 104 TSF patients in Zhengzhou Orthopaedic Hospital from February 2023 to February 2025 were reviewed,they were divided into two groups based on surgical plans,52 patients who underwent posterior pedicle screw rod reduction and fixation via the Wiltse approach were assigned to group A,while 52 patients who underwent posterior midline small incision non-fusion surgery were assigned to group B.Surgery-related indicators and incidence of complication,as well as preoperative and postoperative 3-month visual analog scale(VAS)scores,Oswestry disability index(ODI)scores,Cobb angle of kyphosis of the injured vertebra,percentage of anterior vertebral height(AVH),and bone metabolic levels[β-collagen degradation products(β-CTX),osteoprotegerin(OPG),bone gla protein(BGP)]were compared between the two groups.Results The duration of surgery and hospitalization in group A was shorter than that in group B,and the intraoperative bleeding and postoperative drainage volume were lower than those in group B(P＜0.05).The VAS and ODI scores of group A were lower than those of group B at 3 months after surgery(P＜0.05).Three months after surgery,the Cobb angle of the vertebral kyphosis in group A was lower than that in group B,and the AVH percentage was higher than that in group B(P＜0.05).The serum levels of β-CTX in group A were lower than those in group B at 3 months after surgery,while OPG and BGP were higher than those in group B(P＜0.05).The incidence of complications in group A[1.92％(1/52)]was lower than that in group B[15.38％(8/52)](P＜0.05).Conclusion Compared to posterior midline small incision non-fusion surgery for TSF patients,posterior pedicle screw rod reduction and fixation via the Wiltse approach is more conducive to optimizing surgery-related indicators,reducing the risk of complications,alleviating postoperative pain,restoring normal spinal structure and stability,and improving limb dysfunction and bone metabolism levels.
Keywords：thoracolumbar spine fracturescomplicationsposterior pedicle screw rod reduction and fixation via Wiltse approachbone metabolism
Publication Date：2026-01-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 261-265 )