The Feasibility Study Of The Stability Of Thoracolumbar Tuberculosis Evaluated By Denis Three-column Theory

Objective: To investigate the feasibility study of the stability of thoracolumbar tuberculosis evaluated by Denis three- column theory, in order to guide the clinical treatment.Methods : To collect the clinical materials(including :CT,X-ray,MRI ect.) of 102 patients with thoracolumbar tuberculosis in Orthopedic department of Affiliated Hospital of Zunyi Medical College from Jan 2013 to Jan 2015.To study the lesionvertebal and lower intervertebral disc in individual a total of 268 segments.According to Denis three--column theory, 1.Descriptions of damage of 268 segments of in anterior column, mid column, posterior column, anterior-posterior column,three-column,anterior-mid column,mid-posterior column,respectively;2. Descriptions of damage of unstable segment in anterior column, mid column, posterior column, anterior-posterior column,three-column,anterior-mid column,mid- posterior column,respectively;3.To analysis the relationship between unstable segments and the damage of three-column.4.Is there statistical significance between the damage in one column,two column,three column respectively and unstable segments by chi-square test, Calculate the value of r,to understand the correlations between numbers of damaged column and numbers of unstable segments.Results: 1.Damages in anterior column :21, mid column:5, posterior column:1, anterior-mid column:216, three-column:23, anterior-posterior column:1, mid-posterior column:1,respectively from all the 268 segments;2.Damages in anterior-mid column: 23, three columns:16,respectively from 92 unstable segments,There were no unstable segments in anterior column, mid column, posterior column, anterior-posterior column,mid- posterior column.There was damage of mid-column in all 92 unstable segments,at least involving two columns.3.Damaged in one column was 27 without unstable segment,Damages in two column was 218,including :76 segments of unstable,Damaged in three was 23,including 16 segments of unstable;4.The statistical result was P<0.05(P=0.001),representing significance.There is not all identical between damage in one column,two column and three column and numbers of unstable segment,The value of r was 0.236,0<r < 1 representing the positive correlation existing in numbers of damages and numbers of unstable segment.Conclusions: 1.Mid-column pays key role in stability of thoracolumbar tuberculosis;2.Damage define to mid column only can not cause unstable in thoracolumbar tuberculosis;3.Two or three of damaged columns in thoracolumbar tuberculosis cause unstable;4. Denis three-column theory can evaluate the stability of thoracolumbar tuberculosis well.