| Objective: Study and evaluate a new surgical technique——anteriorcolumn reconstruct with self-made lunular bone cement complex in thetreatment of thoracolumbar diseases spinal tuberculosis.Method: From October 2004 to March 2007, 40 patients withthoracic, thoracolumber spinal tuberculosis admited in Xiangya SecondHospital were treated surgically. The study patients were divided into twogroups by the surgery they received .They are 20 cases of lunular bonecement complex group(10 cases with posterior focus instrumentationand 10 cases with anterior focus instrumentation) and 20 cases oftitanium mesh cage group(10 cases with posterior focus instrumentationand 10 cases with anterior focus instrumentation). All the patients weretreated with intervertebal allografte and followed up by 6-29 month aftersurgery(19.1±6.9month on average).. All the patients was accepted by2-6 weeks chemotherapy before carrying on surgery and continue it for18～24 months after surgery. All the patients were followed-up:neurological syptom,, tuberculosis recurrence, solid interbody fusion,the charge of surgery, operative time, bleeding volume, the correctionof the postoperation kyphosis angle and its changes. The data wasanalyzed with SPSS(13.0) and the statistical significance was defined asP＜0.05.Result: All the 40 patients was followed up. All of the patients'clinical symptoms had relieved at different degree, significance. In the 20patients of lunular bone cement complex group, operative time needs320±65min on average, bleeding volume in the surgery is 649±128ml on average and the charge of surgery is 600 yuan on averagewhile 20 patients of titanium mesh cage group, operative time needs 345±41min on average, bleeding volume in the surgery is 650±114ml onaverage and the charge of surgery is 15600±5400 yuan on average. The statistical indicate surgical trauma caused by lunular bone cementcomplex group is as same as titanium mesh cage group according the dataof operative time and bleeding volume, while the charge of surgery causedby lunular bone cement complex group is as less as titanium mesh cagegroup. No perioperative complication happened. No recurrence of spinaltuberculosis was noted during the follow-up period. Spinal solid fusion atthe interface between the graft and adjacent vertebral bodies was shownradiologically. No internal fixation failed. The Frankel grade of those whohad signs of spinal pressed was raised. The kyphosis angle of lunularbone cement complex group was 21.85±10.02 degree in thepreoperation and 8.15±5.41 degree in the postoperation. The correctionwas 13.7±6.8 degree and the lost in the follow-up was 2.66±1.96degree. The kyphosis angle of titanium mesh cage group was 21.90±9.41 degree in the preoperation and 14.3±6.2 degree in thepostoperation. The correction was 14.3±6.2 degree and the lost in thefollow-up was 2.15±2.02 degree.The fusion time of lunular bonecement complex group was 6.3±0.8 months on average. The fusiontime of titanium mesh cage group was 6.2±0.5 months.All the data ofthe follow-up have no statistical significance(P＞0.05).Conclusion:1,The effect between lunular bone cement complex group andtitanium mesh cage group are the same in the near future. They have nostatistical significance.2,The effect of lunular bone cement complex group in thetreatment of thoracolumbar spinal tuberculosis is as same as titaniummesh cage group at a specified future date.3,The charge of surgery caused by lunular bone cement complexgroup is as less as titanium mesh cage group.4,Clinical effect in long time follow up needs advanced observe. |
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