A retrospective study of lumbar spine fusion surgery with the Wiltse approach and the traditional approach

DOI: https://doi.org/10.21203/rs.2.22715/v2


Background:This study aim to compare the clinical results such as functional improvement, complications, intraoperative parameters etc. between the Wiltse approach and traditional approach in lumbar spine fusion. Methods: In this retrospective controlled study, from May 2016 to May 2017, 70 patients undergone lumbar spine fusion surgery for lumbar disc herniation or lumbar spondylolisthesis within degree II were randomly divided into 2 groups which include Wiltse approach group (N=35, M:F= 1.06:1, mean age= 52 years) and traditional approach group (N=35, M:F= 1.18:1, mean age= 51 years). Actually, all the 70 cases were consisted of 38 lumbar-disc-herniation patients and 32 degree II lumbar-spondylolisthesis patients. In order to specify the clinical curative effects of the two group patients, several indicators including the operation time, the amount of blood loss and post-operation drainage, the ODI, the concentration of peripheral blood creatine phosphokinase (CK) and the cross sectional area (CSA) in magnetic resonance imaging (MRI) were compared. Results: Compared with traditional group, the Wiltse approach group had a statistically significant small figure on operative time, intraoperative blood loss, post-operative drainage and post-operative ODI (p<0.05).As for the peripheral blood CK levels, the concentration of the Wiltse approach group was lower in 1 day and 3 days after the operation(p<0.05), while the difference of the CK concentration for 7 days post-operation has no statistical significance(p>0.05). Furthermore, for the MRI CSA three months after the operation , the Wiltse approach side,s was bigger than the traditional side,s in the Wiltse approach group; the Wiltse approach group,s was bigger than the traditional group,s of the two group,s non-decompression side(p<0.05).Conclusion: For lumbar spinal fusion surgery, the Wiltse approach do have such advantages as shorter operation time, smaller vertebral side muscle injury and better lumbar functional recovery compared with the traditional approach, but as a surgeon, while determining operation program, we should take into account the may influence of the inconsistency of paravertebral muscle anatomy in different levels.

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