Effect of Wiltse Approach for Pedicle Screw Fixation on the Function of Spinal Structure and Electro-physiological Condition of Multifidus in Patients with Lumbar Disc Herniation

Abstract：Objective To investigate the effect of wiltse approach for pedicle screw fixation on the spinal structure and multifidus in patients with lumbar disc herniation.Methods We retrospectively researched 74 cases of patients who were diagnosed with single segmental lumbar disc herniation and underwent surgical treatments in our hospital from October 2014 to August 2015.The patients were randomly divided into the observation group(37 cases)and control group(37 cases).They received non fusion internal fixation through Wiltse approach and posterior midline approach re-spectively.The surgical treatment,the recovery of spinal structure and function,the morphology and electrophysiologi-cal condition of the multiple muscles,the incidence of adverse reactions were compared between the two groups.Results Both of the two groups had 2 cases of patients lost in the follow-up.The operation time of the two groups had no sig-nificant difference(P>0.05),the intraoperative blood loss and postoperative drainage of the observation group was less than the control group,and its length of stay was shorter.The differences were statistically significant(P<0.05).12 and 24 months after the surgery,lumbar VAS score in the observation group was lower than the control group,and the ROM in the observation group was smaller than the control group,and the difference was statistically significant(P<0.05),while there was no statistical difference on JOA score,ODI score,PDH and FH between the two groups(P>0.05).After the treatment,compared with the control group,the observation group had larger multifidus cross-sectional area,lower fatty infiltration classification,higher median frequency and mean amplitude of multifidus,and the difference were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions be-tween the two groups(P>0.05).Conclusion Compared with the posterior midline approach,patients with Wiltse approach for pedicle screw fixation's operation have better condition,the structure and function of the spinal column are restored quickly, and the effect on the multifidus is smaller.It is safe method and worthy of popularization and application.