A Comparative Study Of Posterior Surgery And Anterior-posterior Surgery In The Treatment Of Spinal Tuberculosis

Research background:Bone and joint tuberculosis was once a very common infectious disease, half of which involved the spine.Most of the spinal tuberculosis is vertebra body tuberculosis,few of which is vertebral accessories.5% of spinal tuberculosis is cervical tuberculosis,25% is thoracic tuberculosis,20% is lumbar and sacral tuberculosis.With the widespread use of antituberculotic gluey drugs and with the improve verb of living conditions, the incidence rate of bone and joint tuberculosis dropped.In recent years, the bone and joint tuberculosis incidence rate showed an increasing trend.There ere an annual increase of 800-1000 worldwild.The tuberculosis deaths is three million every year. China is one of the world's 22 tuberculosis high-burden countries, it is the second in the world. The medical workers of all over the world have payed attention to it. In order to alleviate the pain, improve the living conditions, short the course of chemotherapy, reduce the rate of the drug complications of the patients with spinal TB, the medical workers of all over the world have worked hard to improve the surgical technique and medical apparatus and instruments.Now there are all kinds of surgical techniques. With this background, let's now explore a better surgical technique for the single-segment spinal tuberculosis.Objective:To evaluate its indication and clinically applied value by a comparative study of posterior surgery and anterior-posterior surgery in the treatment of spinal tuberculosis.Methods:Six hundred and fifty spinal tuberculosis cases were treated surgically at the Xiangya hospital, the department of spinal surgery, between January 2004 and January 2010. And three hundred and eight cases were treated by posterior surgery or anterior-posterior surgery.we divide 308 cases into two groups based on surgery. The two group cases were followed up postoperatively. The hospital stays, hospitalisation, the operation's time and blood loss, Cobb angel, incidence of relapse,incidence of complication, JOA grade, fusion status of the two groups were documented.Results:The patients were evaluated and followed for at least 24 months (range, 6 to 48 months). The average follow up was 35.14±9.79 months. All patients achieved solid interbody bone union. Each group had only 1 sinus. The Cobb angle did not change. There was not statistical significance in JOA grade of the two groups. The posterior surgery was better than anterior-posterior surgery in the hospital stays, hospitalisation, the operation's time and blood loss and corrective rate of kyphosis.Conclusion:The posterior surgery is better than anterior-posterior surgery in the hospital stays,hospitalisation, the operation's time and blood loss and corrective rate of kyphosis,which is indicative to single-segment spinal tuberculosis or skip spinal tuberculosis.