The Clinical Effect Of Posterior Approach For Thoracolumbar Spinal Tuberculosis

ObjectiveTo investigate the clinical outcomes of posterior approach associated with debridement, bone grafting and internal fixation with pedical screws for Spinal tuberculosis.MethodsFifty eight patients (27 males and 31 females) with Spinal tuberculosis after debridement, bone grafting and internal fixation with pedical screws between February 2007 and September 2014 were reviewed retrospectively, whose average age was 50.6 years old (range from 23 to 85 years old) and average history was 7.1 months (range from 1 month to 31 months). Preoperative imaging information for Incidence of parts:11 cases with thoracic, thoracolumbar 8 cases,29 cases of the lower lumbar spine, lumbosacral 6 cases,4 cases with multi-segmental lesions.All patients had varying degrees of paraspinal abscess:3 cases involving the dural sac,5 caseswith significantly abscess formation,42 cases with obvious damage of bone,52 caseswith intervertebral narrowing and 3 cases with sinus formation. The assessment standard contain Cobb’s angle, bone fusion, Visual Analogue Score and postoperative complications.ResultsSignificant difference were detected in the Cobb’s angle between Preoperative and postoperative (Preoperative 23.6°±10.3°, ostoperative 11.2°±4.9°, P<0.05), while no statistical difference between postoperative and the last follow-up. All patient have bone fusion with the average time of 5.2 months (range from 3.5months to 8.0 months). There was obvious difference in the Visual Analogue Score after operation (Preoperative 5.7±1.1, postoperative2.3±0.7).17 cases with spine cord injury Preoperative (C 3cases, D 14cases for the standard of Frankle), while C-grade patients remained C 1 cases E 2 cases and D patients with three cases of grade D,11 cases of E grade for the final follow-up. All patients have good recovery except 2 cases recurrence and 1 patient with lower back pain.ConclusionPosterior approach associated with debridement, bone grafting and internal fixation with pedical screws was an effective treatment for Spinal tuberculosis.