Clinical Analysis Of One-stage Posterior Modified Incision In The Treatment Of Thoracic Vertebrae Tuberculosis

BackgroundTuberculosis of the thoracic spine is the most common type of tuberculosis of the spine.In recent years,The surgery of posterior approach has been widely applied in clinical treatment of thoracic vertebrae tuberculosis.we modified the incision for the traditional both-approaches,that is,using a posterior approach with arc incision to do focus debridement,bone graft and spinal internal fixation,which achieved good clinical results.In this clinical study,we compared the clinical data of patents who accepted modified arc incision single posterior approach and traditional both-approaches,hoping to provide evidence for clinical surgical approach choices.ObjectivesTo compare the results of the two surgical approaches on treatment of thoracic vertebrae tuberculosis,including: modified arc incision single posterior approach and traditional both-approaches.To explore the advantages and disadvantages of the two surgical approaches and provide references for selecting a better surgical approache.Methods68 patients who had accepted surgical treatment of thoracic vertebrae tuberculosis from August 2009 to August 2016 were include,which were divided into two groups according to different surgical approaches.The experimental group include 32 cases who did focus debridement,autogenous bond graft,and nail-stick internal fixation by the modified arc incision single posterior approach.The control group include 36 cases who did nail-stick internal fixation by traditional both-approach,did focus debridement and autologous bone graft fusion by lateral approach.Several indicators of the two groups,including perioperative evaluation indicators(operation time,intraoperative blood loss,and postoperative hospital stay),imaging observation indicators(Cobb’s correction angle),laboratory inspection and observation indicators(erythrocyte sedimentation rate and C-reactive protein),nerve function recovery status,complication rate,and tuberculosis recurrence status,were compared and analyzed in this paper.Results1.The operation time and blood loss of the experimental group are both less than those of the control group,the difference between the two groups was statistically significant(P<0.05).The difference of postoperative hospital stay between the two groups was no statistical significance(P>0.05).2.The postoperative Cobb’s angle of the experimental group was no statistical significance(P>0.05).And the Degree of Cobb’s Angle correction is higher than that of the control group,the difference between the two groups was statistically significant(P<0.05)3.the erythrocyte sedimentation rate and C-reactive protein on 1 or 3 months after surgery between the two groups was no statistical significance(P>0.05).The postoperative nerve function recovery rate was no statistical significance(P>0.05).4.The complication rate of the experimental group was 15.6% which is lower than41.7% in the control group,the difference between the two groups was statistically significant(P<0.05).The recurrence rate of experimental group was 3.2%,which is lower than 19.4% of the control group,the difference between the two groups was statistically significant(P<0.05).ConclusionsCompared with the patients treated with the traditional both-approach,who treated with the posterior modified arc-incision approach had shorter operation time,less trauma,less intraoperative blood loss,better spinal stability,lower incidence of complications and recurrence.