Comparative Analysis Of Clinical Effects Of Two Different Approaches In The Treatment Of Thoracolumbar Tuberculosis

ObjectiveBy comparing the perioperative data and postoperative follow-up data of patients with thoracolumbar tuberculosis treated by simple posterior approach and combined anterior and posterior approach,the clinical efficacy of two different approaches was analyzed.MethodThe clinical data of 45 patients with thoracolumbar spinal tuberculosis who received surgical treatment in the second affiliated Hospital of Nanchang University from October 2017 to October 2022 were analyzed retrospectively.Among them,29 cases were treated with posterior focus debridement,bone graft fusion and internal fixation,and 16 cases were treated with anterior focus debridement,bone graft fusion and posterior internal fixation.The differences of intraoperative blood loss and operation time,as well as the changes of clinical symptoms,laboratory indexes and imaging indexes before and after operation were compared between the two groups,and the clinical effects of the two approaches were evaluated comprehensively.ResultThe amount of intraoperative bleeding and surgical time in the simple posterior approach group were smaller than those in the anterior and posterior combination group,with a statistically significant difference(P<0.05);The postoperative CRP,ESR,VAS scores,ODI scores,and Cobb angle of the two groups were significantly improved compared to those before surgery,with a statistically significant difference(P<0.05);There was no significant difference in postoperative CRP,ESR,VAS scores,ODI scores,and Cobb angle between the two groups(P>0.05).ConclutionSimple posterior or combined anterior and posterior approaches can achieve ideal treatment results for thoracolumbar tuberculosis.For short segment thoracolumbar tuberculosis,a simple posterior approach has the advantages of minimally invasive and efficient treatment compared to a combined anterior and posterior approach.